Individual
COLLEEN FAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
170 WILLIAM ST, NEW YORK, NY 10038-2612
(112) 312-5000
Mailing address
170 WILLIAM ST, NEW YORK, NY 10038-2612
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110007343
VA
363A00000X
Physician Assistant
Primary
025330
NY
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/19/2020
Last updated
07/28/2020
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