Healthcare Provider Details

I. General information

NPI: 1477648350
Provider Name (Legal Business Name): FAKHRY YOUNAN ALEXANDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 11/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9719 LEFFERTS BLVD
SOUTH RICHMOND HILL NY
11419-1235
US

IV. Provider business mailing address

97-19 LEFFERTS BLVD
RICHMONDHILL NY
11419
US

V. Phone/Fax

Practice location:
  • Phone: 718-846-1900
  • Fax: 718-441-9347
Mailing address:
  • Phone: 718-846-1900
  • Fax: 718-441-9347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number135193
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number135193
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: