Individual
DR. FAIRYAL KASSAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
201 E 65TH ST, NEW YORK, NY 10065-6701
(212) 847-4700
Mailing address
14516 99TH AVE NE, BOTHELL, WA 98011-7274
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD60491262
WA
Other
Enumeration date
07/14/2011
Last updated
01/12/2021
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