Healthcare Provider Details

I. General information

NPI: 1154764496
Provider Name (Legal Business Name): ALINA FUCHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2013
Last Update Date: 06/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5925 15TH AVE
BROOKLYN NY
11219
US

IV. Provider business mailing address

5925 15TH AVE
BROOKLYN NY
11219-5009
US

V. Phone/Fax

Practice location:
  • Phone: 718-972-2700
  • Fax: 718-532-1724
Mailing address:
  • Phone: 718-972-2700
  • Fax: 718-532-1724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number293287
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: