MEDICARE: PAUL JOHN FOX 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
1	207RC0000X	Cardiovascular Disease Physician	129977	NY

General Provider Information

NPI Number	:	1730382292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL JOHN FOX MD

Provider Business Mailing Address
First Line	:	3320 GLENWOOD RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-2724
Country	:	US
Telephone Number	:	718-434-2499
Fax Number	:

Provider Business Practice Location Address
First Line	:	3320 GLENWOOD RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-2724
Country	:	US
Telephone Number	:	718-434-2499
Fax Number	:

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

Provider Enumeration Date	:	06/11/2007
Last Update Date	:	07/08/2007

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