Dr. Gavriel Fuzaylov
Internal Medicine

Address: 98-51 Queens Blvd, Suite 1d, Rego Park, NY 11374
Phone: 7188970327

Dr. Gavriel Fuzaylov (NPI# 1154332310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1154332310
Entity Type Individual
Full Name Dr. Gavriel Fuzaylov
Credential MD
Gender Male
Practice Address 98-51 Queens Blvd
Suite 1d
Rego Park
NY 11374
Practice Telephone 7188970327
Practice Fax Number 7188970237
Mailing Address 98-51 Queens Blvd
Suite 1d
Rego Park
NY 11374
Sole Proprietor Yes, this individual is a Sole Proprietor
Enumeration Date 2006-08-11
Last Update Date 2011-05-02

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 207R00000X Internal Medicine Allopathic & Osteopathic Physicians 200199 NY

Other Provider Identifier

State Identifier Issuer Type Code
NY 01586676 MEDICAID

Physician Overview

NPI 1154332310
PAC ID by PECOS 1951444264
Professional Enrollment ID I20100209000638
Full Name Gavriel Fuzaylov
Gender M
Graduation Year 1983
Primary Specialty INTERNAL MEDICINE
Accepts Medicare Assignment Y
Report Quality Measures Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
330195 NS/LIJ HS LONG ISLAND JEWISH MEDICAL CENTER
330214 NEW YORK UNIVERSITY LANGONE MEDICAL CENTER

Individual EP (Eligible Professionals) Public Reporting – Performance Scores
Physician Quality Reporting System (PQRS) and non-PQRS Qualified Clinical Data Registry (QCDR)

Measure Identifier Measure Title Performance Rate Reporting Mechanism
PQRS_EP_48_1 Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older 100%

Office Location

Street Address 98-51 QUEENS BLVD
SUITE 1D
City REGO PARK
State NY
Zip Code 11374

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1265432470 Carl Solowey 98-05 63 Road, Apt. 1m, Rego Park, NY 11374 2005-07-29
1629050968 Kenneth Philip Schob 97-07 63rd Rd, Rego Park, NY 11374 2005-11-14
1164491890 Vladimir Onefater 9785 Queens Blvd, Rego Park, NY 11374 2006-03-15
1285695049 Robert Mcrae Hip Qmhs 97-45 Qns Blvd., Rego Park, NY 11374 2006-03-31
1447212147 Andre Strizhak 9785 Queens Blvd, Rego Park, NY 11374 2006-04-06
1568426914 Edward Moss 9785 Queens Blvd, Rego Park, NY 11374 2006-04-13
1710935754 Sami Nathan 6352 Woodhaven Blvd, Rego Park, NY 11374 2006-05-04
1649213968 Corey Eliot Lerner 64-20 Saunders St, Rego Park, NY 11374 2006-06-14
1780629501 Roman Aulov 98-76 Queens Blvd, Suite 1k, Rego Park, NY 11374 2006-06-17
1144246067 Jeffrey Steven Rosner 95-08 Queens Boulevard, Rego Park, NY 11374 2006-07-14
Find all providers in zip 11374

Taxonomy Information

Taxonomy Code 207R00000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine

Taxonomy Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1912907742 Stella Ilyaev 9876 Queens Blvd, Suite 1k, Rego Park, NY 11374-4398 2005-07-22
1558353763 Ajay Jain 65-11 Booth Street, Suite 1c, Rego Park, NY 11374-4184 2005-08-16
1194712398 William Howard Hilfer 6404 99th St, Rego Park, NY 11374-2648 2005-10-03
1144208497 Mukul Khurana 65-11 Booth Street, Suite 1c, Rego Park, NY 11374-4184 2006-01-06
1790750859 Naum Meyerovich 9811 Queens Blvd, Suite 1e, Rego Park, NY 11374-3323 2006-02-22
1366401853 Marvin J Base 65-11 Booth Street, Suite 1c, Rego Park, NY 11374-4184 2006-03-22
1982665261 Moisey Delman 9508 Queens Blvd, #1e, Rego Park, NY 11374-1159 2006-03-28
1659332377 Marissa T. Santos 9229 Queens Blvd, Suite Cb, Rego Park, NY 11374-1056 2006-03-31
1063474138 Darius Winter 9785 Queens Blvd, Rego Park, NY 11374-3319 2006-04-04
1326000498 Mani Ushyarov 9785 Queens Blvd, Rego Park, NY 11374-3319 2006-04-04
Find all providers in REGO PARK

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City REGO PARK
Zip Code 11374

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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