Healthcare Provider Details

I. General information

NPI: 1770164204
Provider Name (Legal Business Name): YEVGENIY FURMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2021
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 36TH ST
VERO BEACH FL
32960-4862
US

IV. Provider business mailing address

2201 HEMPSTEAD TPKE
EAST MEADOW NY
11554-1859
US

V. Phone/Fax

Practice location:
  • Phone: 786-942-9813
  • Fax:
Mailing address:
  • Phone: 516-296-2899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS22259
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2026006981
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: