MEDICARE: JULIA FAHEY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	169349	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730253378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA FAHEY M.D.

Provider Business Mailing Address
First Line	:	105 W MAIN ST
Second Line	:
City	:	PATCHOGUE
State	:	NY
Zip	:	11772-3003
Country	:	US
Telephone Number	:	631-687-2969
Fax Number	:	631-687-2970

Provider Business Practice Location Address
First Line	:	105 W MAIN ST
Second Line	:
City	:	PATCHOGUE
State	:	NY
Zip	:	11772-3003
Country	:	US
Telephone Number	:	631-687-2969
Fax Number	:	631-687-2970

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	11/09/2017

Similar Medicare Providers

1104823996 — BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER, INC.
Practice Location Address:

103 WEST MAIN STREET
PATCHOGUE, NY
11772-3003

Practice Phone: 631-758-3600
Practice Fax: 631-758-3615

1609877364 — NYU LANGONE HOSPITALS
Practice Location Address:

105 WEST MAIN STREET
PATCHOGUE, NY
11772-3003

Practice Phone: 631-687-2960
Practice Fax: 631-687-2970

1487743480 — NYU LANGONE HOSPITALS
Practice Location Address:

109 WEST MAIN STREET
PATCHOGUE, NY
11772-3003

Practice Phone: 631-687-2828
Practice Fax: 631-687-2879

1164932315 — MRS. JENNY FALTER-SOUTO RN, BSN
Practice Location Address:

109 W MAIN ST
PATCHOGUE, NY
11772-3003

Practice Phone: 631-687-4188
Practice Fax: 631-687-2879

1306350715 — BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER, INC.
Practice Location Address:

103 W MAIN ST
PATCHOGUE, NY
11772-3003

Practice Phone: 631-687-4188
Practice Fax: 631-687-2879

1063058576 — MRS. EILEEN MARY SMITH RN BSN
Practice Location Address:

103 W MAIN ST
PATCHOGUE, NY
11772-3003

Practice Phone: 631-687-4188
Practice Fax:

Directions to “ JULIA FAHEY M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.