Vitaliy Fatakhov, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F351197-01 Issued in NY

Practice address

9618 63Rd Dr # 202
Rego Park, NY 11374-2297

Phone

(347) 806-2666

Fax

(718) 889-6906

NPI assigned

Mar 21, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1699477745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9618 63RD DR # 202",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742297",
            "telephone_number": "347-806-2666",
            "fax_number": "718-889-6906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9618 63RD DR # 202",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742297",
            "telephone_number": "347-806-2666",
            "fax_number": "718-889-6906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATAKHOV",
        "first_name": "VITALIY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-21",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F351197-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Eye Center Inc
• Jack Jienan Fang, M.D.
• Farnaz Fahimirad
• Fasttrack Urgent Care PLLC
• Rosy Fatakhov
• Nagmo M Fatakhova, M.D.
• Yekaterina Fatakhova, MD
• Natella Fayzibayev
• Daniel Fayziyev
• Natalya Fazylova, NP

• Family Nurse Practitioner in Rego Park, NY
• Providers in Rego Park, 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 Jun 18, 2026; 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.