Active NPI
Gaofeng Fan, M.D., PH.D.
- Anatomic Pathology & Clinical Pathology Physician
- East Meadow, NY
National Provider Identifier
1407018120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- NOT YET
- Practice address
- 2201 Hempstead Tpke
Department of Pathology, Numc
East Meadow, NY 11554-1859 - Phone
- (516) 572-3202
- NPI assigned
- Jun 25, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | NOT YET | NY | Primary |
Addresses
Primary practice location
2201 Hempstead Tpke
Department of Pathology, Numc
East Meadow, NY 11554-1859
Mailing address
2201 Hempstead Tpke
Department of Pathology
East Meadow, NY 11554-1859
Phone (516) 572-3202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NOT YET | NY | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214352000000",
"number": "1407018120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2201 HEMPSTEAD TPKE",
"address_2": "DEPARTMENT OF PATHOLOGY",
"city": "EAST MEADOW",
"state": "NY",
"postal_code": "115541859",
"telephone_number": "516-572-3202",
"fax_number": "516-572-8894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2201 HEMPSTEAD TPKE",
"address_2": "DEPARTMENT OF PATHOLOGY, NUMC",
"city": "EAST MEADOW",
"state": "NY",
"postal_code": "115541859",
"telephone_number": "516-572-3202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAN",
"first_name": "GAOFENG",
"credential": "M.D., PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-25",
"last_updated": "2008-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "NY",
"license": "NOT YET",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Meadow, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.