Provider Demographics
NPI:1497067383
Name:ITA NAGY, FANNY (MD)
Entity Type:Individual
Prefix:MS
First Name:FANNY
Middle Name:
Last Name:ITA NAGY
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 1:3450 WAYNE AVE
Mailing Address - Street 2:APT 19D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2510
Mailing Address - Country:US
Mailing Address - Phone:202-621-3041
Mailing Address - Fax:
Practice Address - Street 1:3450 WAYNE AVE
Practice Address - Street 2:APT 19D
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2510
Practice Address - Country:US
Practice Address - Phone:202-621-3041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY277763207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease