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1629362439
EMANUEL YUSUPOV
ELMHURST, NY
NPI
1629362439
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: NY 014745)
Enumeration Date
2011-06-09
Last Update Date
2011-06-09
Business Address
Mr. EMANUEL YUSUPOV PA
79-01 BROADWAY
ELMHURST, NY 11373
Phone number: 718-334-1921
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Mailing Address
Mr. EMANUEL YUSUPOV PA
79-01 BROADWAY
ELMHURST, NY 11373
Phone number: 718-334-1921
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