Healthcare Provider Details

I. General information

NPI: 1558363788
Provider Name (Legal Business Name): ANASTASIA FOKAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 05/21/2020
Certification Date: 05/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3080 ATLANTIC AVE
BROOKLYN NY
11208-1268
US

IV. Provider business mailing address

1918 23RD DR
ASTORIA NY
11105-3722
US

V. Phone/Fax

Practice location:
  • Phone: 718-206-7001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number234389
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: