MEDICARE: ARTHUR C FOUGNER M.D.

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
1	207V00000X	Obstetrics & Gynecology Physician	121483	NY

General Provider Information

NPI Number	:	1558341222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARTHUR C FOUGNER M.D.

Provider Business Mailing Address
First Line	:	4312 PARSONS BLVD
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11355-2162
Country	:	US
Telephone Number	:	718-353-7571
Fax Number	:	718-460-1322

Provider Business Practice Location Address
First Line	:	4312 PARSONS BLVD
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11355-2162
Country	:	US
Telephone Number	:	718-353-7571
Fax Number	:	718-460-1322

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	08/13/2008

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