Individual
JULIA YUSUPOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2510 30TH AVE, ASTORIA, NY 11102-2448
(718) 932-1000
Mailing address
6350 WETHEROLE ST APT 2J, REGO PARK, NY 11374-2918
(646) 280-6841
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
NY
Other
Enumeration date
09/21/2018
Last updated
09/21/2018
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