Provider Demographics
NPI:1164484135
Name:FRUMKIN, DALIA (MD)
Entity Type:Individual
Prefix:
First Name:DALIA
Middle Name:
Last Name:FRUMKIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12320 82ND AVE
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-1207
Mailing Address - Country:US
Mailing Address - Phone:718-830-3333
Mailing Address - Fax:
Practice Address - Street 1:12320 82ND AVE
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-1207
Practice Address - Country:US
Practice Address - Phone:718-830-3333
Practice Address - Fax:718-830-3722
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209155207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02161388Medicaid
NY02161388Medicaid
NYA400005459Medicare PIN
NY40118IMedicare UPIN