Healthcare Provider Details

I. General information

NPI: 1962466813
Provider Name (Legal Business Name): FERNANDO ARTURO GINEBRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2006
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 SAINT NICHOLAS AVE
BROOKLYN NY
11237-4167
US

IV. Provider business mailing address

10 SURREY RD
NEW HYDE PARK NY
11040-2036
US

V. Phone/Fax

Practice location:
  • Phone: 718-484-8488
  • Fax: 718-484-8487
Mailing address:
  • Phone: 516-352-1819
  • Fax: 718-424-8487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number197158
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number197158
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: