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General NPI Number Information
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NPI Number | 1255652020
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Entity Type | Individual
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Provider Name | CATHY FAN MD
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Gender | Female
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Dates
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Enumeration Date | 06/16/2010
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Last Update Date | 06/17/2024
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Provider Practice Location Address
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Address Line | 506 6TH STREET
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City | PARK SLOPE
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State | NY
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Zip | 11215-1433
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Country | US
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Telephone | 718-380-3672
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Fax | 718-780-3672
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Provider Business Mailing Address
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Address Line | 506 6TH ST NYP-BMH DEPARTMENT OF PATHOLOGY
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City | PARK SLOPE
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State | NY
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Zip | 11215
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Country | US
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Telephone | 718-780-3672
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Fax | 718-780-3673
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 241734
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License Number State | NY
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