Provider Demographics
NPI:1831451277
Name:SAFIYEV, YEFIM
Entity type:Individual
Prefix:
First Name:YEFIM
Middle Name:
Last Name:SAFIYEV
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 1:916 CARMANS RD
Mailing Address - Street 2:SUITE 165A
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-3505
Mailing Address - Country:US
Mailing Address - Phone:917-617-0071
Mailing Address - Fax:
Practice Address - Street 1:916 CARMANS RD
Practice Address - Street 2:SUITE 165A
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-3505
Practice Address - Country:US
Practice Address - Phone:917-617-0071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008978-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician