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General NPI Number Information
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NPI Number | 1285872515
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Entity Type | Organization
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Legal Business Name | SHERRILL FAY, DMD, PC
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Dates
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Enumeration Date | 01/23/2009
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Last Update Date | 04/16/2015
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Provider Practice Location Address
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Address Line | 253 W 72ND ST #216
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City | NEW YORK
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State | NY
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Zip | 10023-2705
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Country | US
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Telephone | 973-714-1863
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Fax |
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Provider Business Mailing Address
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Address Line | 253 W 72ND ST #216
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City | NEW YORK
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State | NY
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Zip | 10023-2705
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHERRILL FAY
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Credential | DMD, MD
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Telephone | 973-714-1863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 052966
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License Number State | NY
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