Organization
F THEMISTOCLE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FENAR THEMOSTOCLE MD (OWNER)
(718) 924-7909
Entity
Organization
Contact information
Practice address
2445 ARTHUR AVE, BRONX, NY 10458-6003
(718) 924-7909
Mailing address
9601 SPRINGFIELD BLVD, QUEENS VILLAGE, NY 11429-1327
(718) 924-7909
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
217744
NY
208VP0000X
Pain Medicine Physician
Primary
217774
NY
261QP3300X
Pain Clinic/Center
217744
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02161351
—
NY
Enumeration date
06/12/2009
Last updated
01/08/2010
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