ABBYDEK FAMILY MEDICAL PRACTICE PC NPI 1447535323

NPI Information

ABBYDEK FAMILY MEDICAL PRACTICE PC is a primary care clinic center in Flushing, NY. ABBYDEK FAMILY MEDICAL PRACTICE PC NPI is 1447535323. The provider is registered as an organization entity type.
The provider Is Doing Business As Emmanuel O Fashakin Md.

The provider's business location address is:

7935 153RD ST
APT 1
FLUSHING, NY
ZIP 11367-937
Phone: (718) 591-1600
Fax: (718) 591-0265

The provider's authorized official is Emmanuel Olusegun Fashakin .
The authorized official title is President and has the following contact phone number (718) 591-1600.

The CLIA number assigned to this NPI record is 33D0935326 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/11/2011 and was last updated on 10/11/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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