# DR. JONATHAN DEAN FAY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1245592625
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 283073 | NY | — |
| 207W00000X | Ophthalmology Physician | MD181538 | OR | Yes |
| 207WX0120X | Cornea and External Diseases Specialist Physician | MD181538 | OR | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | NULL | — |

## Other

- **Enumeration date:** 06/12/2012
- **Last updated:** 10/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 500725690 | — | OR |
| 05 | — | MEDICAID | — | NY |