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General NPI Number Information
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NPI Number | 1477112191
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Entity Type | Individual
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Provider Name | PETER FATHY TEMSAH MD
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Gender | Male
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Dates
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Enumeration Date | 06/06/2019
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 800 ROSE ST
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City | LEXINGTON
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State | KY
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Zip | 40536-2501
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Country | US
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Telephone | 859-323-2222
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Fax | 859-323-5090
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Provider Business Mailing Address
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Address Line | 6610 GRAND AVE APT 2A
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City | MASPETH
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State | NY
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Zip | 11378-2501
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Country | US
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Telephone | 201-471-8112
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Fax |
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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 | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | NA
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207UN0902X
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Taxonomy Name | Nuclear Imaging & Therapy Physician
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License Number | 60179
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License Number State | KY
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