Doctor Name: | DR. BRIAN FAY |
NPI Number: | 1992136147 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD, ATP, RET |
License Number: | |
Business Practice Address: | 1 Veterans Dr Mc 117 Minneapolis, MN - 554172309 |
Business Phone Number: | 6124675285 |
Business Fax Number: | |
Mailing Address: | 1 Veterans Dr, Mc 117 MINNEAPOLIS |
State: | MN |
Postal Code: | 554172309 |
Phone Number: | 6124675285 |
Fax Number: | |
NPI Enumeration Date: | 12/12/2013 |
NPI Last Update Date: | 03/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225500000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Specialist/Technologist |
Taxonomy Specialization: | |
Taxonomy Definition: | General classification identifying individuals who are trained on a specific piece of equipment or technical procedure. |