REGO PARK MEDICAL ASSOCIATE,P.C
Ambulatory Health at Queens Blvd, Flushing, NY

License number
New York 200199
Category
Ambulatory Health
Type
Primary Care
Owner
Name: DR. GAVRIEL FUZAYLOV M D
Title: PRESIDENT
Phone: (718) 897-0327
Address
Address
9851 Queens Blvd SUITE 1D, Flushing, NY 11374
National Provider ID: 1215268669
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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REGO PARK MEDICAL ASSOCIATE, PC

Flushing, NY

Registration:
Jan 30, 1997
Addresses:
98-51 Queens Blvd STE 1D, Maspeth, NY 11378 (Physical)
98-51 Queens Blvd, Rego Park, NY 11374 (Physical)
State ID:
2108054
Business type:
DOMESTIC PROFESSIONAL CORPORATION
Gavriel Fuzaylov Md, 98-51 Queens Blvd STE 1D, Rego Park, NY 11374 (Physical)

Ambulatory Health licenses in New York