Individual
ARI FOZAILOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPHT, RN
Contact information
Practice address
14715 73RD AVE, FLUSHING, NY 11367-2929
(718) 362-0588
Mailing address
14715 73RD AVE, FLUSHING, NY 11367-2929
(718) 362-0588
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
643217
NY
183700000X
Pharmacy Technician
260100103070984
NY
Other
Enumeration date
10/25/2010
Last updated
12/11/2016
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