Healthcare Provider Details

I. General information

NPI: 1043263098
Provider Name (Legal Business Name): FERNANDO A PUJOL-MORATO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 6TH ST
BROOKLYN NY
11215-3609
US

IV. Provider business mailing address

200 CONGRESS ST APT 3C
BROOKLYN NY
11201-6537
US

V. Phone/Fax

Practice location:
  • Phone: 718-636-7400
  • Fax: 718-636-7432
Mailing address:
  • Phone: 718-636-7400
  • Fax: 718-636-7432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number163062
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number163062
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: