Provider Demographics
NPI:1649377326
Name:ATTIYEH, FADI F (MD)
Entity type:Individual
Prefix:DR
First Name:FADI
Middle Name:F
Last Name:ATTIYEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:FADI
Other - Middle Name:F
Other - Last Name:ATTIYEH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:425 W 59TH ST
Mailing Address - Street 2:SUITE 8B-1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1104
Mailing Address - Country:US
Mailing Address - Phone:212-307-1144
Mailing Address - Fax:212-307-0074
Practice Address - Street 1:425 W 59TH ST
Practice Address - Street 2:SUITE 8B-1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1104
Practice Address - Country:US
Practice Address - Phone:212-307-1144
Practice Address - Fax:212-307-0074
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1260882086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00591433Medicaid
NY33F191OtherEMPIRE BC/BS
NY33F191Medicare ID - Type Unspecified
NY33F191OtherEMPIRE BC/BS