Provider Demographics
NPI:1669449393
Name:AKAZAWA, FUMIYO (DO)
Entity Type:Individual
Prefix:
First Name:FUMIYO
Middle Name:
Last Name:AKAZAWA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:465 COLUMBUS AVE
Mailing Address - Street 2:DOCS CONTINUUM MEDICAL GROUP
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595
Mailing Address - Country:US
Mailing Address - Phone:914-749-7000
Mailing Address - Fax:914-769-1824
Practice Address - Street 1:141 SOUTH CENTRAL PARK AVE
Practice Address - Street 2:JAPANESE MEDICAL PRACTICE C/O DOCS
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530
Practice Address - Country:US
Practice Address - Phone:914-997-9300
Practice Address - Fax:914-997-2418
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY212052207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H15297Medicare UPIN
NY1C4651Medicare ID - Type Unspecified