Provider Demographics
NPI:1487841110
Name:FAKIOGLU, ESRA (MD)
Entity type:Individual
Prefix:DR
First Name:ESRA
Middle Name:
Last Name:FAKIOGLU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18904 UNION TPKE FL 1
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1862
Mailing Address - Country:US
Mailing Address - Phone:347-230-2454
Mailing Address - Fax:646-580-0908
Practice Address - Street 1:18904 UNION TPKE FL 1
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1862
Practice Address - Country:US
Practice Address - Phone:347-230-2454
Practice Address - Fax:646-580-0908
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2663652080P0208X, 208000000X, 2080B0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
No2080B0002XAllopathic & Osteopathic PhysiciansPediatricsObesity Medicine