Organization
SONOMA MEDICAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ARKADY YUSUPOV MD (PRESIDENT)
(347) 624-3341
Entity
Organization
Contact information
Practice address
21 WASHINGTON AVE, BRENTWOOD, NY 11717-3215
(347) 624-3341
(347) 789-7415
Mailing address
1361 BROADWAY APT B32, HEWLETT, NY 11557-1342
(347) 624-3341
(347) 789-7415
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
09/15/2020
Last updated
09/15/2020
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