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Individual

MR. GEORGIY YUSUPOV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3709 FLATLANDS AVE, BROOKLYN, NY 11234-3507
(718) 444-7766
Mailing address
14020 68TH DR, FLUSHING, NY 11367-1652
(646) 331-5198

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F347371-01
NY

Other

Enumeration date
03/16/2021
Last updated
03/25/2021
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