Doctor Name: | VIOLLETA FUZAYLOV |
NPI Number: | 1457595373 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 019822 |
Business Practice Address: | 6511 Booth St Suite 1 C Rego Park, NY - 113744181 |
Business Phone Number: | 3477381197 |
Business Fax Number: | |
Mailing Address: | 6511 Booth St, Suite 1 C REGO PARK |
State: | NY |
Postal Code: | 113744181 |
Phone Number: | 3477381197 |
Fax Number: | |
NPI Enumeration Date: | 04/22/2009 |
NPI Last Update Date: | 06/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 019822 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |