Michele J Fagan
Pediatric Emergency Doctor
Mmc - Peds. Emergency Medicine 111 East 210th Street
Bronx
, New York 10467
Michele J Fagan
Pediatric Emergency Doctor
Mmc - Peds. Emergency Medicine 111 East 210th Street
Bronx
, New York 10467
(718) 798-6485
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About
Features
Specialties
- Pediatric Emergency Doctor
Languages spoken
- English
Location
First Address
- Michele J Fagan
- 165 Bennett Ave Apt. 4g
- New York, NY
- Zip : 10040-4013
- Fax : (718) 798-6485
- Phone : (718) 920-5312
Second Address
- Michele J Fagan
- Mmc - Peds. Emergency Medicine 111 East 210th Street
- Bronx, NY
- Zip : 10467
- Phone : (718) 920-5312
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0204X | Pediatric Emergency Doctor | 212908 | NY |
National Provider Identifier
| NPI | 1255417523 |
|---|---|
| Provider Name | Michele J Fagan |
| First Address | New York, NY 10040-4013 |
| Second Address | Bronx, NY 10467 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/10/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.