Individual
LEV YAGUDAYEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7585 181ST ST, FRESH MEADOWS, NY 11366-1609
(917) 686-5073
Mailing address
7585 181ST ST, FRESH MEADOWS, NY 11366-1609
(917) 686-5073
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
244286
NY
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
244286
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
244286
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02966810
—
NY
01
—
244286
LICENSE
NY
Enumeration date
08/08/2007
Last updated
08/25/2023
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