MEDICARE: DR. IBRAHIM FATIHA CHIROPRACTIC,P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	010318	NY

General Provider Information

NPI Number	:	1538507116
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. IBRAHIM FATIHA CHIROPRACTIC,P.C.

Provider Business Mailing Address
First Line	:	618 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-4132
Country	:	US
Telephone Number	:	718-569-5458
Fax Number	:	718-569-5459

Provider Business Practice Location Address
First Line	:	618 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-4132
Country	:	US
Telephone Number	:	917-335-9868
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. IBRAHIM FATIHA
Credential	:	DC
Telephone Number	:	718-569-5458

Provider Enumeration Date	:	06/05/2013
Last Update Date	:	08/20/2021

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