Fattakhov, Ruben

Fattakhov, Ruben is an individual health care provider with primary practice located at 105-10 62 Rd Apt 1F, Forest Hills NY 11375. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Fattakhov, Ruben can be contacted via phone (718) 760-8400.

Contact Information

Primary practice address
105-10 62 Rd Apt 1F Forest Hills NY 11375
Fax: (718) 760-8114
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 046847 New York

Profile Details

NPI number 1821147372
LBN Legal business name Fattakhov, Ruben
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821147372 NPPES
New York MEDICAID 01709737

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