Individual
DANA YUSUPOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2201 HEMPSTEAD TPKE, EAST MEADOW, NY 11554-1859
(718) 864-4574
Mailing address
2201 HEMPSTEAD TPKE, EAST MEADOW, NY 11554-1859
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
060787
NY
Other
Enumeration date
04/09/2018
Last updated
09/24/2019
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