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Individual

NAIL BAGAUTDINOV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
701 W 189TH ST, APT 1 C, NEW YORK, NY 10040-4039
(646) 510-4868
Mailing address
701 W 189TH ST, APT 1 C, NEW YORK, NY 10040-4039
(646) 510-4868

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
268055
NY
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
39027
KY

Other

Enumeration date
04/19/2006
Last updated
11/12/2013
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