Organization
LUIZA GUSEYNOV,PHYSICIAN,PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIZA GUSEYNOV M.D. (PHYSICIAN)
(718) 432-0200
Entity
Organization
Contact information
Practice address
3108 KINGSBRIDGE AVE, GROUND FLOOR,OFFICE B, BRONX, NY 10463-3956
(718) 432-0200
(718) 432-0201
Mailing address
16832 POWELLS COVE BLVD, WHITESTONE, NY 11357-1523
(718) 432-0200
(718) 432-0201
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
233370
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02625643
—
NY
Enumeration date
08/19/2010
Last updated
08/19/2010
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