Provider Demographics
NPI:1346502481
Name:FATA, TONIANN (BA SP ED)
Entity Type:Individual
Prefix:MISS
First Name:TONIANN
Middle Name:
Last Name:FATA
Suffix:
Gender:F
Credentials:BA SP ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15645 84TH ST
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-2645
Mailing Address - Country:US
Mailing Address - Phone:718-738-1800
Mailing Address - Fax:718-848-8683
Practice Address - Street 1:15645 84TH ST
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-2645
Practice Address - Country:US
Practice Address - Phone:718-738-1800
Practice Address - Fax:718-848-8683
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist