Individual
ESTER FAZYLOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
820 MERRICK RD, BALDWIN, NY 11510-3354
(516) 584-0100
Mailing address
6155 98TH ST APT 9M, REGO PARK, NY 11374-1438
(646) 510-3787
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
061104
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/04/2019
Last updated
06/22/2025
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