MEDICARE: IMANUEL FUZAILOV PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	031215	NY

General Provider Information

NPI Number	:	1235379827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IMANUEL FUZAILOV PT

Provider Business Mailing Address
First Line	:	721 MELROSE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10455-1121
Country	:	US
Telephone Number	:	718-554-0064
Fax Number	:	718-554-0221

Provider Business Practice Location Address
First Line	:	721 MELROSE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10455-1121
Country	:	US
Telephone Number	:	718-554-0064
Fax Number	:	718-554-0221

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2009
Last Update Date	:	01/17/2017

Similar Medicare Providers

1710523584 — MRS. TAMARA BEN-SHIMON
Practice Location Address:

721 MELROSE AVE
BRONX, NY
10455-1121

Practice Phone: 917-753-8915
Practice Fax:

1700019783 — MARIYA FUZAYLOVA OTR/L
Practice Location Address:

721 MELROSE AVE
BRONX, NY
10455-1121

Practice Phone: 718-554-0064
Practice Fax: 718-554-0221

1003108358 — OPTIMAL REHABILITATION OT&PT PLLC
Practice Location Address:

721 MELROSE AVE
BRONX, NY
10455-1121

Practice Phone: 917-803-5276
Practice Fax: 718-762-1510

1821461864 — OPTIMAL REHABILITATION OT & PT, PLLC
Practice Location Address:

721 MELROSE AVE
BRONX, NY
10455-1121

Practice Phone: 718-554-0064
Practice Fax: 718-554-0221

1457781890 — KIM FAMOUS PA
Practice Location Address:

645 MINNIEFORD AVE
BRONX, NY
10464-1121

Practice Phone: 917-703-5700
Practice Fax:

1285179739 — BERNADETTE MARIE MCMAHON
Practice Location Address:

611 MINNIEFORD AVE
BRONX, NY
10464-1121

Practice Phone: 718-885-1197
Practice Fax:

Directions to “ IMANUEL FUZAILOV PT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.