Individual
TAMARA FUZAYLOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
10245 62ND RD APT 4K, FOREST HILLS, NY 11375-1019
(718) 607-1009
Mailing address
10245 62ND RD APT 4K, FOREST HILLS, NY 11375-1019
(718) 607-1009
Taxonomy
Speciality
Code
Description
License number
State
146M00000X
Intermediate Emergency Medical Technician
Primary
013923-1
NY
Other
Enumeration date
05/14/2010
Last updated
05/14/2010
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