Healthcare Provider Details

I. General information

NPI: 1063474930
Provider Name (Legal Business Name): FRUMKIN NEPHROLOGY ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 05/22/2024
Certification Date: 05/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9715 64TH RD LOWR LEVEL
REGO PARK NY
11374-2250
US

IV. Provider business mailing address

30 E 37TH ST APT M
NEW YORK NY
10016-3019
US

V. Phone/Fax

Practice location:
  • Phone: 718-830-3333
  • Fax: 718-830-3722
Mailing address:
  • Phone: 718-830-3333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: DALIA FRUMKIN
Title or Position: MD
Credential:
Phone: 718-830-3333