Provider Demographics
NPI:1821676206
Name:ABDELFATTAH, AYA EMAD (MBBCH, MPH)
Entity type:Individual
Prefix:
First Name:AYA
Middle Name:EMAD
Last Name:ABDELFATTAH
Suffix:
Gender:F
Credentials:MBBCH, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 SARATOGA RD
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12302-4211
Mailing Address - Country:US
Mailing Address - Phone:518-243-3360
Mailing Address - Fax:
Practice Address - Street 1:115 SARATOGA RD
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12302-4211
Practice Address - Country:US
Practice Address - Phone:518-243-3360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-29
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY331466207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine