Individual
FANNY OK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
622 W 168TH ST RM VC-260, NEW YORK, NY 10032-3720
(212) 305-6059
Mailing address
622 W 168TH ST RM VC-260, NEW YORK, NY 10032-3720
(212) 305-6059
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
025299
NY
Other
Enumeration date
07/07/2020
Last updated
05/10/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
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