Individual
MOHAMAD YOUSUF FAZILI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3469 HARLEM RD, CHEEKTOWAGA, NY 14225-2001
(716) 833-3008
(716) 833-3009
Mailing address
3469 HARLEM RD, CHEEKTOWAGA, NY 14225-2001
(716) 833-3008
(716) 833-3009
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
123086
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00020506201
UNIVERA HEALTHCARE
NY
01
—
000507548001
BLUE CROSS/BLUE SHIELD
NY
05
—
00657034
—
NY
01
—
1704040
INDEPENDENT HEALTH
NY
Enumeration date
06/19/2006
Last updated
07/09/2007
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