Individual
DR. FADI MIRZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
622 W 168TH ST, PH 16-66, NEW YORK, NY 10032-3720
(212) 305-6293
Mailing address
622 W 168TH ST, PH 16-66, NEW YORK, NY 10032-3720
(212) 305-6293
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
003520
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02248786
—
NY
05
—
02559635
—
NY
Enumeration date
04/02/2007
Last updated
05/12/2010
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