Individual
DANIEL FAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 HOSPITAL RD, PATCHOGUE, NY 11772-4870
(631) 654-7100
Mailing address
31 PAUL CT, NORTH BABYLON, NY 11703-1122
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
020313
NY
363AS0400X
Surgical Physician Assistant
020313
NY
Other
Enumeration date
10/25/2016
Last updated
10/25/2016
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