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General NPI Number Information
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NPI Number | 1154312403
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Entity Type | Individual
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Provider Name | NATALYA B FAYNBOYM MD
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Gender | Female
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Dates
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Enumeration Date | 11/03/2005
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Last Update Date | 04/07/2010
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Provider Practice Location Address
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Address Line | 9165 W THUNDERBIRD RD STE 100
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City | PEORIA
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State | AZ
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Zip | 85381-4847
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Country | US
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Telephone | 623-523-6560
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Fax | 623-523-6581
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Provider Business Mailing Address
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Address Line | 13640 N PLAZA DEL RIO BLVD
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City | PEORIA
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State | AZ
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Zip | 85381-4846
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Country | US
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Telephone | 623-876-3800
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Fax | 623-876-6965
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 34352
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 2007-00545
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License Number State | NC
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