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Individual

DR. DAVID FAGAN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2016 BRONXDALE AVE, STE 203, BRONX, NY 10462-3365
(718) 597-0700
(718) 597-9500
Mailing address
180 W OLIVE ST, LONG BEACH, NY 11561-3314
(516) 705-5170
(718) 597-9500

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
210189
NY

Other

Enumeration date
05/28/2005
Last updated
07/08/2007
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