INNOVATIVE REHABILITATION CONSULTANT MEDICAL PC (NPI# 1770880403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770880403 |
| Entity Type | Organization |
| Organization Name | INNOVATIVE REHABILITATION CONSULTANT MEDICAL PC |
| Practice Address |
21429 Jamaica Ave Queens Village NY 11428-1733 |
| Practice Telephone | 7184654540 |
| Enumeration Date | 2011-02-15 |
| Last Update Date | 2011-02-15 |
| Authorized Official Name | DR. DMITRIY FUZAYLOV (OWNDER) |
| Authorized Official Telephone | 6467843984 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
241269 | NY | Ambulatory Health Care Facilities |
| Street Address |
21429 JAMAICA AVE |
| City | QUEENS VILLAGE |
| State | NY |
| Zip Code | 11428-1733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013422203 | Lim Acupuncture PC | Acupuncturist | 21429 Jamaica Ave, Queens Village, NY 11428-1733 | 2017-12-10 |
| 1184998015 | Refreshing Medical PC | Family Medicine | 21429 Jamaica Ave, Queens Village, NY 11428-1733 | 2012-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770117574 | Introgen, Inc. | Durable Medical Equipment & Medical Supplies | 212-27 Jamaica Ave, Queens Village, NY 11428 | 2020-03-02 |
| 1972084366 | State of New York Comptrollers Office | Clinic/Center | Fineson Ddsoo Clinic, 80-45 Winchester Blvd Bldg 80, Queens Village, NY 11428 | 2018-08-24 |
| 1083108674 | Patricia Ngozi Okoye-oyibo | Licensed Practical Nurse | Home Care At Its Best Inc., 221-21 Jamaica Ave, Queens Village, NY 11428 | 2018-06-18 |
| 1497278782 | Jea Early Intervention Services | Early Intervention Provider Agency | 93-46 215 Street, Queens Village, NY 11428 | 2017-07-19 |
| 1649790569 | Super Tech Wheelchair Service and Repair Inc | Durable Medical Equipment & Medical Supplies | 9420 210th Street, Queens Village, NY 11428 | 2017-06-21 |
| 1003368861 | Anr Homecare Services, LLC | Home Health | 217-02 Jamaica Avenue 2nd Fl, Queens Village, NY 11428 | 2016-10-27 |
| 1619426327 | Chinedu Ogueri | Licensed Practical Nurse | 9220 216 Th St, Queensvillage, NY 11428 | 2016-09-23 |
| 1083168520 | Mma Shukur | Registered Nurse | 9111 218th St, Queens Village, NY 11428 | 2016-08-13 |
| 1548631880 | Randall Ramnarain | Pharmacist | 102-05 Jamaica Ave, Richmond Hill, NY 11428 | 2015-10-13 |
| 1265809172 | Jackie R. Chessen Consulting | Early Intervention Provider Agency | 221-17 91 Road, Queens Village, NY 11428 | 2015-08-26 |
| Find all providers in zip 11428 | ||||
| Taxonomy Code | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528221 | Cmf Care Inc | Clinic/Center | 118 Baxter St Ste 206, New York, NY 10013-3675 | 2020-11-04 |
| 1154931335 | Integrity Medical Pllc | Clinic/Center | 58 Commack Rd, Commack, NY 11725-3402 | 2020-08-03 |
| 1699239715 | Mk Spine and Joint Rehab, P.C. | Clinic/Center | 27 Vanderbilt Pkwy, Dix Hills, NY 11746-5815 | 2019-01-23 |
| 1245700111 | Pranevicius Medical P.C. | Clinic/Center | 300 Albany St Apt 6e, New York, NY 10280-1452 | 2018-12-04 |
| 1154801033 | Paradigm Family Health Np Pllc | Clinic/Center | 40 Gardenville Pkwy Ste 101, West Seneca, NY 14224-1387 | 2018-08-20 |
| 1164918835 | Integrated Interventional Pain Management PC | Clinic/Center | 20712 Northern Blvd Ste 3, Bayside, NY 11361-3108 | 2018-07-06 |
| 1912433186 | Pain Management Acupuncture | Clinic/Center | 135 Sullys Trl Ste 3, Pittsford, NY 14534-4564 | 2017-05-10 |
| 1376086777 | Quick Docs Medical, Pllc | Clinic/Center | 1975 Flatbush Ave, Brooklyn, NY 11234-2811 | 2016-12-02 |
| 1356891766 | Centurion Pain Management | Clinic/Center | 601 W 163rd St, New York, NY 10032-5632 | 2016-10-10 |
| 1588044697 | Jodi M Gentili | Clinic/Center | 301 Vanderbilt Ave, Apt 2, Brooklyn, NY 11205-3604 | 2015-06-03 |
| Find all providers with the same taxonomy | ||||
| City | QUEENS VILLAGE |
| Zip Code | 11428 |
Please comment or provide details below to improve the information on INNOVATIVE REHABILITATION CONSULTANT MEDICAL PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.