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General NPI Number Information
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NPI Number | 1487667242
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Entity Type | Individual
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Provider Name | KATHLEEN M. FAHEY R.N.
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Gender | Female
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 111 E 210TH ST MAP 4 DEPT OF SURGERY
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City | BRONX
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State | NY
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Zip | 10467-2401
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Country | US
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Telephone | 718-920-5961
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Fax | 718-798-1883
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Provider Business Mailing Address
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Address Line | 73 CATALPA PL
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City | BRONX
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State | NY
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Zip | 10465-3808
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Country | US
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Telephone | 718-823-7716
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Fax |
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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 | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 4342851
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License Number State | NY
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