Doctor Name: | DR. KIRAN ALI FATEH |
NPI Number: | 1740591189 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.O. |
License Number: | |
Business Practice Address: | 1000 East Mountain Blvd. Wilkes-barre, PA - 187113539 |
Business Phone Number: | 5708087399 |
Business Fax Number: | 5708085647 |
Mailing Address: | 100 North Academy Ave., DANVILLE |
State: | NY |
Postal Code: | 178224903 |
Phone Number: | 5702716144 |
Fax Number: | |
NPI Enumeration Date: | 06/30/2010 |
NPI Last Update Date: | 03/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |