Individual
JAMES C FAGIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 DAKOTA DRIVE, SUITE 312, LAKE SUCCESS, NY 11042
(516) 608-2898
(516) 608-2897
Mailing address
2800 MARCUS AVE, NEW HYDE PARK, NY 11042-1113
(516) 622-6000
(516) 608-2897
Taxonomy
Speciality
Code
Description
License number
State
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
136140
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01120598
—
NY
Enumeration date
10/03/2006
Last updated
09/20/2018
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