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Organization
GEORGE G. FAIREY MD
Active
Organization
GEORGE G. FAIREY MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE G. FAIREY M.D. (OWNER)
(631) 689-5155
Entity
Organization
Contact information
Practice address
1212 N COUNTRY RD STE 2A, STONY BROOK, NY 11790-1919
(631) 689-5155
Mailing address
1212 N COUNTRY RD STE 2A, STONY BROOK, NY 11790-1919
(631) 689-5155
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
129972
NY
261QM0850X
Adult Mental Health Clinic/Center
129972
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00509146
—
NY
Enumeration date
10/13/2006
Last updated
09/11/2025
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