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NPI Code Detail

MEDICARE: GEORGE FERNAINE MD

MEDICARE: GEORGE FERNAINE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician222114-1NY

General Provider Information

NPI Number : 1184731119
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE FERNAINE MD
Provider Business Mailing Address
First Line : 6740 4TH AVE FL 2
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-5350
Country : US
Telephone Number : 929-455-2740
Fax Number : 929-455-2750
Provider Business Practice Location Address
First Line : 6740 4TH AVE FL 2
Second Line :
City : BROOKLYN
State : NY
Zip : 11220-5350
Country : US
Telephone Number : 929-455-2740
Fax Number : 929-455-2750
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2006
Last Update Date : 03/29/2021

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