Basic Information
| Provider Information | |||||||||
| NPI: | 1821471251 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FN MEDICAL SERVICES P.C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9732 63RD RD | ||||||||
| Address2: | |||||||||
| City: | REGO PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113741639 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182752224 | ||||||||
| FaxNumber: | 7182759600 | ||||||||
| Practice Location | |||||||||
| Address1: | 9732 63RD RD | ||||||||
| Address2: | |||||||||
| City: | REGO PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113741639 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182752224 | ||||||||
| FaxNumber: | 7182759600 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2015 | ||||||||
| LastUpdateDate: | 07/02/2015 | ||||||||
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| AuthorizedOfficialLastName: | FATAKHOVA | ||||||||
| AuthorizedOfficialFirstName: | NAGMO | ||||||||
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| AuthorizedOfficialTitleorPosition: | PSYCHIATRIST | ||||||||
| AuthorizedOfficialTelephone: | 7182752224 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 2190091 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.