Provider Demographics
NPI:1861578585
Name:FRESKO, OYA (MD)
Entity type:Individual
Prefix:
First Name:OYA
Middle Name:
Last Name:FRESKO
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 1:1900 HEMPSTEAD TURNPIKE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554
Mailing Address - Country:US
Mailing Address - Phone:516-542-1090
Mailing Address - Fax:516-794-8165
Practice Address - Street 1:LINDEN BLVD BROOKDALE PLAZA
Practice Address - Street 2:BROOKDALE HOSPITAL MEDICAL CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212
Practice Address - Country:US
Practice Address - Phone:718-240-5415
Practice Address - Fax:718-240-5424
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY134161207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY71A471Medicare ID - Type Unspecified
B18912Medicare UPIN