Individual
FATAI LASISI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13801 SPRINGFIELD BLVD, SPRINGFIELD GARDENS, NY 11413-2632
(718) 723-7269
(718) 723-7262
Mailing address
13801 SPRINGFIELD BLVD, SPRINGFIELD GARDENS, NY 11413-2632
(718) 723-7269
(718) 723-7262
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
668842755
NY
Other
Enumeration date
05/11/2016
Last updated
05/11/2016
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