Individual
ASA CHAIM FUZAILOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2601 OCEAN PKWY, BROOKLYN, NY 11235-7745
(718) 616-3440
Mailing address
2601 OCEAN PKWY, BROOKLYN, NY 11235-7791
(718) 616-3440
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
023110-1
NY
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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