Individual
KATHLEEN M. FAHEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
111 E 210TH ST, MAP 4 DEPT OF SURGERY, BRONX, NY 10467-2401
(718) 920-5961
(718) 798-1883
Mailing address
73 CATALPA PL, BRONX, NY 10465-3808
(718) 823-7716
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
4342851
NY
Other
Enumeration date
08/14/2006
Last updated
07/08/2007
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