Provider Demographics
NPI:1194041517
Name:YUSUFOV, ORKHAN
Entity Type:Individual
Prefix:MR
First Name:ORKHAN
Middle Name:
Last Name:YUSUFOV
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2076 86TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-3215
Mailing Address - Country:US
Mailing Address - Phone:718-449-2909
Mailing Address - Fax:718-449-2910
Practice Address - Street 1:2076 86TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-3215
Practice Address - Country:US
Practice Address - Phone:718-449-2909
Practice Address - Fax:718-449-2910
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies