Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Emanuel Yusupov, PA

Individual provider Surgical Physician Assistant · NPI 1629362439

Mr. Emanuel Yusupov, PA is a Surgical Physician Assistant in Elmhurst, New York. Licensed in New York. Registered with an NPI since 2011.

Licensed in
NY
In the registry since
2011
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

79-01 Broadway
Elmhurst, NY 11373
Phone: (718) 334-1921
Fax: (718) 334-5958
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 014745 (NY)

Record details

NPI number1629362439
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 9, 2011
Last updated in NPPESJune 9, 2011

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