Provider Demographics
NPI:1972047447
Name:FOO, JAMES FANE (DPT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:FANE
Last Name:FOO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 E 1ST ST
Mailing Address - Street 2:OFC LN
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-9393
Mailing Address - Country:US
Mailing Address - Phone:646-907-9593
Mailing Address - Fax:
Practice Address - Street 1:62 E 1ST ST OFC LN
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-9393
Practice Address - Country:US
Practice Address - Phone:212-327-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-18
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040975225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist