Healthcare Provider Details
I. General information
NPI: 1699708107
Provider Name (Legal Business Name): JANET M FAGHIHI D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/08/2006
Last Update Date: 05/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
55 MAIN ST
HASTINGS ON HUDSON NY
10706-1601
US
IV. Provider business mailing address
55 MAIN ST
HASTINGS ON HUDSON NY
10706-1601
US
V. Phone/Fax
- Phone: 914-478-8120
- Fax: 914-478-1818
- Phone: 914-478-8120
- Fax: 914-478-1818
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | N005396 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: