Healthcare Provider Details

I. General information

NPI: 1669848032
Provider Name (Legal Business Name): FAUZIYA PARKAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2015
Last Update Date: 11/23/2020
Certification Date: 11/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E 210TH ST
BRONX NY
10467-2401
US

IV. Provider business mailing address

111 E 210TH ST
BRONX NY
10467-2401
US

V. Phone/Fax

Practice location:
  • Phone: 718-929-5506
  • Fax:
Mailing address:
  • Phone: 718-929-5506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number25MA10819000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: