Provider Demographics
NPI:1053295444
Name:FUZAYLOV, ARSEN
Entity type:Individual
Prefix:
First Name:ARSEN
Middle Name:
Last Name:FUZAYLOV
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:577 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6377
Mailing Address - Country:US
Mailing Address - Phone:212-686-8666
Mailing Address - Fax:212-686-5566
Practice Address - Street 1:577 2ND AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6377
Practice Address - Country:US
Practice Address - Phone:212-686-8666
Practice Address - Fax:212-686-5566
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician