Individual
ALEXANDER YAKOV FACTOUROVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10-42 MITCHELL AVE, BINGHAMTON, NY 13903-1617
(607) 762-2990
Mailing address
43 SAN MARCO DR, JOHNSON CITY, NY 13790-5017
(607) 729-7955
(607) 729-7955
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
233180
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02601632
—
NY
Enumeration date
05/12/2006
Last updated
12/24/2015
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