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Individual

BELLA FUZAYLOV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SI

Contact information

Practice address
130 BRIGHTON 11TH ST, BROOKLYN, NY 11235-5327
(171) 874-3184
(718) 743-1841
Mailing address
800 CORTELYOU RD APT 5K, BROOKLYN, NY 11218-5291
(917) 297-0081

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1256153
NY

Other

Enumeration date
07/12/2017
Last updated
07/12/2017
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