DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

ANTON FETISOV

Active Sole Proprietor

ANTON FETISOV is a Registered Nurse healthcare provider located in SOUTH FLORAL PARK, New York. NPI 1811698665 is currently active in the NPPES registry. Verify at CMS.

Registered Nurse · SOUTH FLORAL PARK, NY

Registration Details

NPI Number
1811698665
Provider Type
Individual
Gender
Male
NPI Issued
Mar 16, 2023 (3.430669956999 yrs)
Last Updated
Jun 9, 2025
Licenses
033053 (NY)
978345 (NY)
Sole Proprietor
Yes

Practice Information

Address
31 KINGSTON AVE
SOUTH FLORAL PARK, NY, 110013517
Browse NY providers · Browse ZIP 11001
Phone
9299280468
Primary Specialty
Registered Nurse
163W00000X
Additional Specialty
Registered Nurse

Other Registered Nurse Providers in SOUTH FLORAL PARK, NY

Name Credential NPI
MISS CHARMAINE LOIS PITTER RN 1679862213
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.