Provider Demographics
NPI:1942819818
Name:MUSAYEV, ARSEN
Entity Type:Individual
Prefix:MR
First Name:ARSEN
Middle Name:
Last Name:MUSAYEV
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 1:63109 SAUNDERS ST APT D7
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3139
Mailing Address - Country:US
Mailing Address - Phone:347-649-5226
Mailing Address - Fax:
Practice Address - Street 1:63109 SAUNDERS ST APT D7
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3139
Practice Address - Country:US
Practice Address - Phone:347-649-5226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist