Individual
IZABELLA YUSUPOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8268 164TH ST, JAMAICA, NY 11432-1121
(718) 883-3000
Mailing address
8268 164TH ST, JAMAICA, NY 11432-1121
(718) 883-3000
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
306271
NY
Other
Enumeration date
12/03/2012
Last updated
12/04/2012
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