Healthcare Provider Details

I. General information

NPI: 1356802052
Provider Name (Legal Business Name): MUHAMAD AKRAM FESTOK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2019
Last Update Date: 08/30/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 YORK AVE FL 11
NEW YORK NY
10021-5663
US

IV. Provider business mailing address

1126 LEGACY DR
BIRMINGHAM AL
35242-6024
US

V. Phone/Fax

Practice location:
  • Phone: 646-962-2020
  • Fax: 646-962-0603
Mailing address:
  • Phone: 205-746-1394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number327840
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: