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Individual

DR. SHAMY BUSHRA FAZAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
210 E 86TH ST RM 402, NEW YORK, NY 10028-7726
(212) 628-4444
Mailing address
201 E 86TH ST STE 402, NEW YORK, NY 10028-3023
(212) 628-4444

Taxonomy

Speciality
Code
Description
License number
State
213ES0000X
Sports Medicine Podiatrist
Primary
071069-00
NY

Other

Enumeration date
06/10/2020
Last updated
06/10/2020
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