Provider Demographics
NPI:1144307174
Name:ATTIA, CLAIRE WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:WILLIAM
Last Name:ATTIA
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 1:311 PARK ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-1813
Mailing Address - Country:US
Mailing Address - Phone:718-979-1369
Mailing Address - Fax:718-979-8606
Practice Address - Street 1:311 PARK ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-1813
Practice Address - Country:US
Practice Address - Phone:917-750-1238
Practice Address - Fax:718-979-8606
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1614862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01841950Medicaid
NY01841950Medicaid
NY37K401Medicare ID - Type Unspecified