Violleta Fuzaylov, Inc

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

019822 Issued in NY

Legal business name

VIOLLETA FUZAYLOV, INC

Practice address

6511 Booth St
Ste 1 C
Rego Park, NY 11374-4181

Phone

(347) 808-7196

NPI assigned

Sep 13, 2011

Organization subpart

No

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

Authorized official

Name

Violleta Fuzaylov, MS CCC-SLP

Title

Speech Language Pathologist

Phone

(347) 738-1197

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1942582325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6511 BOOTH ST",
            "address_2": "STE 1 C",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6511 BOOTH ST",
            "address_2": "STE 1 C",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744181",
            "telephone_number": "347-808-7196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIOLLETA FUZAYLOV, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "FUZAYLOV",
        "authorized_official_first_name": "VIOLLETA",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "347-738-1197",
        "authorized_official_credential": "MS CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "019822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH ID",
            "identifier": "12249983",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.