Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 020541 | NJ |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 50-052966 | NY |
NPI | 1043273089 |
---|---|
Provider Name | Dr. Sherrill Fay |
First Address | New York, NY 10007-2239 |
Second Address | New York, NY 10007-2239 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 16/04/2015 |