Individual
STAN FUZAYLOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTHALMIC DESPENCER
Contact information
Practice address
1295 1ST AVE, NEW YORK, NY 10021-5584
(212) 535-4469
Mailing address
1295 1ST AVE, NEW YORK, NY 10021-5584
(212) 535-4469
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
009893
NY
Other
Enumeration date
05/05/2016
Last updated
05/05/2016
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