Healthcare Provider Details

I. General information

NPI: 1962460758
Provider Name (Legal Business Name): ADORA-ANN C. FOU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ADORA-ANN C FOU-COCKBURN MD

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 02/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 THEALL RD
RYE NY
10580-1404
US

IV. Provider business mailing address

1 THEALL RD
RYE NY
10580-1404
US

V. Phone/Fax

Practice location:
  • Phone: 914-848-8960
  • Fax: 914-848-8965
Mailing address:
  • Phone: 914-848-8960
  • Fax: 914-848-8965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number236290-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number044694
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: