Healthcare Provider Details

I. General information

NPI: 1437594611
Provider Name (Legal Business Name): FAINA TREYBICH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2013
Last Update Date: 10/18/2021
Certification Date: 10/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 OCEAN PKWY ROOM4N98
BROOKLYN NY
11235-7745
US

IV. Provider business mailing address

2601 OCEAN PKWY ROOM4N98
BROOKLYN NY
11235-7745
US

V. Phone/Fax

Practice location:
  • Phone: 718-616-3779
  • Fax: 718-616-3779
Mailing address:
  • Phone: 718-616-3779
  • Fax: 718-616-3779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number312822-01
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberME153398
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number312822
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: