Individual
FENAR THEMISTOCLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1973 UNIVERSITY AVE, BRONX, NY 10453-4404
(718) 708-8000
(718) 708-8001
Mailing address
1973 UNIVERSITY AVE, BRONX, NY 10453, BRONX, NY 10453-4404
(718) 708-8000
(718) 708-8001
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
217744
NY
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
217744
NY
208VP0000X
Pain Medicine Physician
217744
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02161351
—
NY
Enumeration date
08/09/2005
Last updated
02/02/2015
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