Individual
DR. STEVE YUSUPOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
55 BRYANT AVE, ROSLYN, NY 11576-1139
(516) 749-3000
Mailing address
256-C MASON AVENUE 3RD FLOOR, STATEN ISLAND, NY 10305-1851
(718) 226-1251
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
057086
NY
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
285541
NY
Other
Enumeration date
07/05/2011
Last updated
07/21/2022
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