Individual
DAVID M FASTENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 NORTHERN BLVD, SUITE 216, GREAT NECK, NY 11021
(516) 466-0390
(516) 829-0520
Mailing address
600 NORTHERN BLVD, SUITE 216, GREAT NECK, NY 11021
(516) 466-0390
(516) 829-0520
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
131362
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00710518
—
NY
Enumeration date
08/17/2006
Last updated
11/25/2020
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