Individual
DR. JACK FATIHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
709 AVENUE U, BROOKLYN, NY 11223-4133
(718) 336-0100
(718) 336-7139
Mailing address
709 AVENUE U, BROOKLYN, NY 11223-4133
(718) 336-0100
(718) 336-7139
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
229099
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02495889
—
NY
Enumeration date
08/19/2005
Last updated
04/11/2008
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