Basic Information
| Provider Information | |||||||||
| NPI: | 1194987982 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FATTERPEKAR | ||||||||
| FirstName: | GIRISH | ||||||||
| MiddleName: | MANOHAR | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 660 1ST AVE | ||||||||
| Address2: | 2ND FLOOR, RM 224 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100163295 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122635219 | ||||||||
| FaxNumber: | 2122633838 | ||||||||
| Practice Location | |||||||||
| Address1: | 550 FIRST AVE | ||||||||
| Address2: | NYU LANGONE MED CTR, DEPT OF RADIOLOGY | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122635219 | ||||||||
| FaxNumber: | 2122637878 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2008 | ||||||||
| LastUpdateDate: | 08/10/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085N0700X | 4301091169 | MI | N | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 2085R0202X | 4301091169 | MI | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085N0700X | 268548 | NY | Y | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology |
No ID Information.