Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 141280 | NY |
N | 208600000X | Surgeon | 141280 | NY |
N | 2086S0129X | Vascular Surgeon | 141280 | NY |
NPI | 1063465847 |
---|---|
Provider Name | Dr. John Douglas Fey |
First Address | Syracuse, NY 13210 |
Second Address | Syracuse, NY 13210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 08/07/2007 |