Individual
JAMES MICHAEL FATOLITIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
161 FT. WASHINGTON AVE, 7TH FLOOR PEDS ONC, NEW YORK CITY, NY 10032
(212) 305-9770
(212) 305-5848
Mailing address
730 FORT WASHINGTON AVE APT 5M, NEW YORK, NY 10040-3748
(212) 927-2029
(212) 342-8541
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F381221
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F 381221
NP LICENSE
NY
Enumeration date
03/21/2007
Last updated
07/08/2007
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