| Georgiy Yusupov Family Health Nurse Practitioner P.c. | |
|
13726 70th Rd Flushing NY 11367-1930 | |
| (646) 331-5198 | |
| Not Available |
| Full Name | Georgiy Yusupov Family Health Nurse Practitioner P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 13726 70th Rd, Flushing, New York |
| Authorized Official Name and Position | Georgiy Yusupov (OWNER) |
| Authorized Official Contact | 6463315198 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Georgiy Yusupov Family Health Nurse Practitioner P.c. 13726 70th Rd Flushing NY 11367-1930 Ph: (646) 331-5198 | Georgiy Yusupov Family Health Nurse Practitioner P.c. 13726 70th Rd Flushing NY 11367-1930 Ph: (646) 331-5198 |
| NPI Number | 1003521436 |
|---|---|
| Provider Enumeration Date | 01/19/2023 |
| Last Update Date | 01/19/2023 |
| Medicare PECOS PAC ID | 6204207152 |
|---|---|
| Medicare Enrollment ID | O20230201000258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003521436 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Georgiy E Yusupov |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164007548 PECOS PAC ID: 4587071840 Enrollment ID: I20210402000524 |
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