Healthcare Provider Details

I. General information

NPI: 1720424625
Provider Name (Legal Business Name): INWOOD FAMILY PRACTICE AND OSTEOPATHIC MEDICINE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2013
Last Update Date: 05/23/2022
Certification Date: 05/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 DOUGHTY BLVD
INWOOD NY
11096-2003
US

IV. Provider business mailing address

101 DOUGHTY BLVD
INWOOD NY
11096-2003
US

V. Phone/Fax

Practice location:
  • Phone: 516-239-2924
  • Fax: 516-239-1609
Mailing address:
  • Phone: 347-836-2699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number258868
License Number StateNY

VIII. Authorized Official

Name: DR. ANATOLE HOUNNOU
Title or Position: OWNER
Credential: D.O.
Phone: 347-836-2699