VITALIY FATAKHOV

FRESH MEADOWS, NY
NPI1699477745
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: NY  F351197-01)
Enumeration Date2023-03-21
Last Update Date2023-03-21
Business Address
VITALIY FATAKHOV FNP
7001 173RD ST
FRESH MEADOWS, NY 11365-3449
Phone number: 347-806-2666
Mailing Address
VITALIY FATAKHOV FNP
7001 173RD ST
FRESH MEADOWS, NY 11365-3449
Phone number: 347-806-2666
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