Provider Demographics
NPI:1194987982
Name:FATTERPEKAR, GIRISH MANOHAR (MD)
Entity type:Individual
Prefix:DR
First Name:GIRISH
Middle Name:MANOHAR
Last Name:FATTERPEKAR
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 1:660 1ST AVE
Mailing Address - Street 2:2ND FLOOR, RM 224
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3295
Mailing Address - Country:US
Mailing Address - Phone:212-263-5219
Mailing Address - Fax:212-263-3838
Practice Address - Street 1:550 FIRST AVE
Practice Address - Street 2:NYU LANGONE MED CTR, DEPT OF RADIOLOGY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-263-5219
Practice Address - Fax:212-263-7878
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010911692085N0700X, 2085R0202X
NY2685482085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology