Provider Demographics
NPI:1285279760
Name:AKBAR, FATIMA (PA)
Entity type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:AKBAR
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8269 251ST ST
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426-2527
Mailing Address - Country:US
Mailing Address - Phone:516-603-0703
Mailing Address - Fax:718-347-3028
Practice Address - Street 1:12108 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-1812
Practice Address - Country:US
Practice Address - Phone:718-850-1673
Practice Address - Fax:718-477-5300
Is Sole Proprietor?:No
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYP103575363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant