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General NPI Number Information
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NPI Number | 1801719117
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Entity Type | Organization
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Legal Business Name | ALEXANDR SAFAROV MEDICAL P.C.
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 17 GLEN POND DR STE 4
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City | RED HOOK
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State | NY
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Zip | 12571-1824
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Country | US
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Telephone | 917-443-7626
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Fax |
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Provider Business Mailing Address
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Address Line | 9 QUAIL RIDGE RD
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City | HYDE PARK
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State | NY
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Zip | 12538-2931
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Country | US
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Telephone | 917-443-9940
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALEXANDR SAFAROV
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Credential |
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Telephone | 917-443-9940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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