Provider Demographics
NPI:1104406925
Name:BAWANY, FATIMA RAUF (MD)
Entity type:Individual
Prefix:
First Name:FATIMA
Middle Name:RAUF
Last Name:BAWANY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GREYROCK PL APT 6101
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-3151
Mailing Address - Country:US
Mailing Address - Phone:585-465-3568
Mailing Address - Fax:
Practice Address - Street 1:2777 SUMMER ST STE 600
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-4323
Practice Address - Country:US
Practice Address - Phone:203-428-4440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT81076207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology