Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 245436 | NY |
NPI | 1003010174 |
---|---|
Provider Name | Dr. Alexander Usorov |
First Address | Brooklyn, NY 11217-1702 |
Second Address | Brooklyn, NY 11217-1702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 09/11/2021 |