Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | P05049 | NY |
NPI | 1881119303 |
---|---|
Provider Name | Dr. Ashraf Maher Fansa |
First Address | New York, NY 10021 |
Second Address | New York, NY 10021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2017 |
Last Update Date | 05/08/2017 |