Active NPI
Nelly Fuzaylov, RPH
- Pharmacist
- Fort Hamilton, NY
National Provider Identifier
1407837222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 045593-1
- Practice address
- Ainsworth US Army Health Clinic Pharmacy
Ainsworth US Army Health Clinic BLDG 114
Fort Hamilton, NY 11252-6500 - Phone
- (718) 630-4268
- Fax
- (718) 630-4337
- NPI assigned
- Nov 9, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 045593-1 | NY | Primary |
Addresses
Primary practice location
Ainsworth US Army Health Clinic Pharmacy
Ainsworth US Army Health Clinic BLDG 114
Fort Hamilton, NY 11252-6500
Mailing address
114 White Ave
Ft Hamilton
Brooklyn, NY 11252-9503
Phone (718) 630-4268
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 045593-1 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kotiyark Inc | Current | Accepting new patients | |
| Kotiyark Inc | Current | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277424000000",
"number": "1407837222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 WHITE AVE",
"address_2": "FT HAMILTON",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112529503",
"telephone_number": "718-630-4268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "AINSWORTH US ARMY HEALTH CLINIC PHARMACY",
"address_2": "AINSWORTH US ARMY HEALTH CLINIC BLDG 114",
"city": "FORT HAMILTON",
"state": "NY",
"postal_code": "112526500",
"telephone_number": "718-630-4268",
"fax_number": "718-630-4337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUZAYLOV",
"first_name": "NELLY",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-09",
"last_updated": "2010-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "045593-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Hamilton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.