Provider Demographics
NPI:1407268063
Name:CUMMINS, FAHMINA (PA-C)
Entity type:Individual
Prefix:
First Name:FAHMINA
Middle Name:
Last Name:CUMMINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:FAHMINA
Other - Middle Name:
Other - Last Name:KHAIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3101 VERNON BLVD APT 212
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-4872
Mailing Address - Country:US
Mailing Address - Phone:718-902-5849
Mailing Address - Fax:
Practice Address - Street 1:550 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:347-501-1011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017467363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant