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Individual

MICHAEL CHARLES FAYNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
415 W 23RD ST APT 1F, NEW YORK, NY 10011-1453
(917) 715-2378
Mailing address
415 W 23RD ST APT 1F, NEW YORK, NY 10011-1453
(917) 715-2378

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
010872-1
NY

Other

Enumeration date
01/04/2018
Last updated
01/04/2018
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