Provider Demographics
NPI:1104898949
Name:OVIASU, FELIX I (MD)
Entity type:Individual
Prefix:DR
First Name:FELIX
Middle Name:I
Last Name:OVIASU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 GARDEN CITY PLZ STE 303
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-3336
Mailing Address - Country:US
Mailing Address - Phone:516-742-5700
Mailing Address - Fax:516-742-5701
Practice Address - Street 1:400 GARDEN CITY PLZ
Practice Address - Street 2:SUITE 303
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-3322
Practice Address - Country:US
Practice Address - Phone:516-742-5700
Practice Address - Fax:516-742-5701
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167440174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01049696Medicaid
NY01049696Medicaid
NYA61033Medicare UPIN
18E471Medicare PIN