Individual
DR. EFRAIM FUZAILOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
608 E NEW YORK AVE, BROOKLYN, NY 11203-1106
(718) 774-0144
(718) 774-0244
Mailing address
608 E NEW YORK AVE, BROOKLYN, NY 11203-1106
(718) 774-0144
(718) 774-0244
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
055571
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03359015
—
NY
Enumeration date
07/24/2011
Last updated
03/30/2016
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