Active NPI
Sandzhar Yusupov
- Vehicle Modifications Contractor
- Canton, MA
National Provider Identifier
1154770030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vehicle Modifications Contractor
- Practice address
- 95 Washington St
Ste #474
Canton, MA 02021-4006 - Phone
- (781) 821-3411
- Fax
- (781) 634-0508
- NPI assigned
- Jun 10, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vehicle Modifications Contractor | 171WV0202X | Primary |
Addresses
Primary practice location
95 Washington St
Ste #474
Canton, MA 02021-4006
Mailing address
95 Washington St
Ste #474
Canton, MA 02021-4006
Phone (781) 821-3411
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465516800000",
"number": "1154770030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 WASHINGTON ST",
"address_2": "STE #474",
"city": "CANTON",
"state": "MA",
"postal_code": "020214006",
"telephone_number": "781-821-3411",
"fax_number": "781-634-0508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 WASHINGTON ST",
"address_2": "STE #474",
"city": "CANTON",
"state": "MA",
"postal_code": "020214006",
"telephone_number": "781-821-3411",
"fax_number": "781-634-0508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YUSUPOV",
"first_name": "SANDZHAR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-10",
"last_updated": "2016-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "171WV0202X",
"taxonomy_group": "",
"desc": "Contractor, Vehicle Modifications",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.