Basic Information
| Provider Information | |||||||||
| NPI: | 1497250914 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FATIMA | ||||||||
| FirstName: | HINA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 355 BARD AVE RM 314 | ||||||||
| Address2: | |||||||||
| City: | STATEN ISLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 103101699 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188184636 | ||||||||
| FaxNumber: | 7188182739 | ||||||||
| Practice Location | |||||||||
| Address1: | 355 BARD AVE RM 314 | ||||||||
| Address2: | |||||||||
| City: | STATEN ISLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 103101699 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188184636 | ||||||||
| FaxNumber: | 7188182739 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2018 | ||||||||
| LastUpdateDate: | 03/27/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 1612420 | NY | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.