Individual
ERIC FANAEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
380 MONTAUK HWY, WEST ISLIP, NY 11795-4403
(631) 422-5371
Mailing address
380 MONTAUK HWY, WEST ISLIP, NY 11795-4403
(631) 422-5371
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
125054823
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
125054823
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
265787
NY
Other
Enumeration date
06/22/2010
Last updated
01/26/2022
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