| Dilshad Fakhruddin Medical Pc | |
|
1081 Gates Ave Brooklyn NY 11221-4303 | |
| (646) 420-8110 | |
| Not Available |
| Full Name | Dilshad Fakhruddin Medical Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1081 Gates Ave, Brooklyn, New York |
| Authorized Official Name and Position | Dilshad Fakhruddin (OWNER) |
| Authorized Official Contact | 6464208110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dilshad Fakhruddin Medical Pc 420 64th St Apt 10a Brooklyn NY 11220-4975 Ph: (646) 420-8110 | Dilshad Fakhruddin Medical Pc 1081 Gates Ave Brooklyn NY 11221-4303 Ph: (646) 420-8110 |
| NPI Number | 1629210158 |
|---|---|
| Provider Enumeration Date | 03/30/2009 |
| Last Update Date | 03/30/2009 |
| Medicare PECOS PAC ID | 4688721806 |
|---|---|
| Medicare Enrollment ID | O20090406000010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629210158 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 210936-1 (New York) | Primary |
| Provider Name | Dilshad Fakhruddin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407997174 PECOS PAC ID: 8325107337 Enrollment ID: I20081105000859 |
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