Sarah Shelley Fuzailov

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

353454 Issued in NY

Practice address

8403 Cuthbert Rd
Kew Gardens, NY 11415-2140

Phone

(347) 454-9082

NPI assigned

Aug 22, 2021

Last updated

Nov 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1184390890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14412 70TH RD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671718",
            "telephone_number": "929-401-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8403 CUTHBERT RD",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114152140",
            "telephone_number": "347-454-9082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUZAILOV",
        "first_name": "SARAH",
        "middle_name": "SHELLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-22",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "353454",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "824589",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Freedom Center of Kew Gardens, LLC
• Martha Freese, LMSW
• David Friedman, LCSW
• Jeanne A. Friedman, LCSW, ATR
• Gabriel Fulop, D.D.S.
• Irina Fuzaylova
• Kate Sarah Gallagher, M.S. CCC-SLP
• Peter Gambino, LMSW
• Rosanne Gangi-Gaertner, MA CCC-SLP
• Jacob Ganz, LMHC

• Family Nurse Practitioner in Kew Gardens, NY
• Providers in Kew Gardens, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.