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General NPI Number Information
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NPI Number | 1942180294
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Entity Type | Individual
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Provider Name | NEELA FATAPOUR DDS
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Gender | Female
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Dates
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Enumeration Date | 09/06/2025
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Last Update Date | 09/06/2025
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Provider Practice Location Address
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Address Line | 40 W 117TH ST
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City | NEW YORK
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State | NY
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Zip | 10026-1921
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Country | US
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Telephone | 347-315-3633
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Fax |
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Provider Business Mailing Address
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Address Line | 40 WATERSIDE PLZ APT 7H
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City | NEW YORK
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State | NY
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Zip | 10010-2640
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Country | US
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Telephone | 408-666-0064
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 065082
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License Number State | NY
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