Basic Information
| Provider Information | |||||||||
| NPI: | 1194990820 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | WASSEF | ||||||||
| FirstName: | FADY | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5024 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100875024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8006274470 | ||||||||
| FaxNumber: | 4129375710 | ||||||||
| Practice Location | |||||||||
| Address1: | 2510 30TH AVE | ||||||||
| Address2: | ANESTHESIOLOGY DEPARTMENT | ||||||||
| City: | ASTORIA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 111022448 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8006274470 | ||||||||
| FaxNumber: | 4129375710 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2008 | ||||||||
| LastUpdateDate: | 07/11/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | A120445 | CA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 270532-1 | NY | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.