Provider Demographics
NPI:1710165295
Name:DAWAN, FATIMAH U (DPT)
Entity Type:Individual
Prefix:
First Name:FATIMAH
Middle Name:U
Last Name:DAWAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1681
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-8481
Mailing Address - Country:US
Mailing Address - Phone:347-486-7789
Mailing Address - Fax:929-456-5138
Practice Address - Street 1:554 GRANT AVE
Practice Address - Street 2:
Practice Address - City:NORTH BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-1329
Practice Address - Country:US
Practice Address - Phone:347-486-7789
Practice Address - Fax:929-456-5138
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0293471225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist