Provider Demographics
NPI:1336673565
Name:FATIMA, AMAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:AMAN
Middle Name:
Last Name:FATIMA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8704 ROLLING RD
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4253
Mailing Address - Country:US
Mailing Address - Phone:703-361-3132
Mailing Address - Fax:
Practice Address - Street 1:2911 QUEENS PLZ N APT 25A
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-4045
Practice Address - Country:US
Practice Address - Phone:240-374-3062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-14
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103301292213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist