Provider Demographics
NPI:1669052403
Name:WAFY, FATMA FAWZY ABDALLAHSEMIDA (MBBCH)
Entity type:Individual
Prefix:
First Name:FATMA
Middle Name:FAWZY ABDALLAHSEMIDA
Last Name:WAFY
Suffix:
Gender:F
Credentials:MBBCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 CLARKSON AVE STE 1203
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2054
Mailing Address - Country:US
Mailing Address - Phone:718-270-2902
Mailing Address - Fax:718-270-1441
Practice Address - Street 1:451 CLARKSON AVE STE 1203
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2054
Practice Address - Country:US
Practice Address - Phone:718-270-2902
Practice Address - Fax:718-270-1441
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program