Individual
MR. BARRY OWEN FAGIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1205 8TH AVE, BROOKLYN, NY 11215-5139
(347) 523-2238
Mailing address
1205 8TH AVE, BROOKLYN, NY 11215-5139
(347) 523-2238
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
002694
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P30321
MEDICARE PROVIDER #
NY
Enumeration date
02/13/2008
Last updated
02/13/2008
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