Individual
MRS. ADELINA FAZILOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
450 LAKEVILLE RD, NEW HYDE PARK, NY 11042-1118
(516) 487-9454
(516) 487-2745
Mailing address
450 LAKEVILLE RD, SURGICAL ONCOLOGY, NEW HYDE PARK, NY 11042
(516) 487-9454
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
F350177-01
NY
Other
Enumeration date
11/03/2022
Last updated
11/03/2022
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