INNOVATIVE REHABILITATION CONSULTANT MEDICAL PC
Ambulatory Health at Jamaica Ave, Jamaica, NY

License number
New York 241269
Category
Ambulatory Health
Type
Pain
Owner
Name: DR. DMITRIY FUZAYLOV MD
Title: OWNDER
Phone: (646) 784-3984
Address
Address
21429 Jamaica Ave, Jamaica, NY 11428
National Provider ID: 1770880403
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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INNOVATIVE REHABILITATION CONSULTANT MEDICAL PC

214-29 Jamaica Ave, Queens Village, NY 11428

Registration:
Jan 26, 2011
State ID:
4047453
Business type:
DOMESTIC PROFESSIONAL CORPORATION

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