Organization
SIOMS FOREST HILLS MANAGEMENT LLC
Active
Parent organization
SIOMS FOREST HILLS MANAGEMENT LLC
Other names
SIOMS Woodbury
Organization subpart
Yes
Provider details
NPI number
Legal business name
SIOMS FOREST HILLS MANAGEMENT LLC
Authorized official
STEVE YUSUPOV MD, DDS (MANAGING PARTNER)
(516) 677-9777
Entity
Organization
Contact information
Practice address
167 FROEHLICH FARM BLVD, WOODBURY, NY 11797-2906
(516) 677-9777
Mailing address
167 FROEHLICH FARM BLVD, WOODBURY, NY 11797-2906
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03766474
—
NY
Enumeration date
01/27/2020
Last updated
01/27/2020
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