Individual
FAHAD MALIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
701 CONEY ISLAND AVENUE, APT 5, BROOKLYN, NY 11218
(347) 750-9847
Mailing address
701 CONEY ISLAND AVE, APT 5, BROOKLYN, NY 11218-4327
(347) 750-9847
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TD67315J
—
NY
Enumeration date
08/28/2014
Last updated
08/28/2014
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