Organization
GLOBAL REHABILITATION MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLEG FUZAYLOV MD (SUPERVISING PHYSICIAN)
(718) 275-5200
Entity
Organization
Contact information
Practice address
9701 66TH AVE, REGO PARK, NY 11374-4245
(718) 275-5200
(718) 275-6864
Mailing address
9701 66TH AVE, REGO PARK, NY 11374-4245
(718) 275-5200
(718) 275-6864
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02655154
—
NY
Enumeration date
10/27/2006
Last updated
09/05/2007
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