Doctor Name: | DR. FAWAZ AHMED SAMI AL-MUFTI |
NPI Number: | 1376776153 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 241152 |
Business Practice Address: | 710 W 168th St New York, NY - 100323726 |
Business Phone Number: | 2123057236 |
Business Fax Number: | 2123052792 |
Mailing Address: | 710 W 168th St, NEW YORK |
State: | NY |
Postal Code: | 100323726 |
Phone Number: | 2123057236 |
Fax Number: | 2123052792 |
NPI Enumeration Date: | 08/27/2009 |
NPI Last Update Date: | 07/11/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 241152 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |