Provider Demographics
NPI:1861646721
Name:CHULPAYEV, ARTUR
Entity Type:Individual
Prefix:
First Name:ARTUR
Middle Name:
Last Name:CHULPAYEV
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 1:9750 QUEENS BLVD
Mailing Address - Street 2:APT D15
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3252
Mailing Address - Country:US
Mailing Address - Phone:917-544-1503
Mailing Address - Fax:
Practice Address - Street 1:16102 UNION TPKE
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1900
Practice Address - Country:US
Practice Address - Phone:718-969-0090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008856156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician