MEDICARE: ANASTASIA FOKAS 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	208000000X	Pediatrics Physician	234389	NY

General Provider Information

NPI Number	:	1558363788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANASTASIA FOKAS M.D.

Provider Business Mailing Address
First Line	:	1918 23RD DR
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11105-3722
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3080 ATLANTIC AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-1268
Country	:	US
Telephone Number	:	718-206-7001
Fax Number	:

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	05/21/2020

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