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NPI Code Detail

MEDICARE: DR MAUREEN FAHEY AND ASSOCIATES

MEDICARE: DR MAUREEN FAHEY AND ASSOCIATES
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
1152W00000XOptometristOD00003148WA

Other Identifiers

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

General Provider Information

NPI Number : 1679675276
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR MAUREEN FAHEY AND ASSOCIATES
Provider Business Mailing Address
First Line : 117 N ELY ST
Second Line :
City : KENNEWICK
State : WA
Zip : 99336-2941
Country : US
Telephone Number : 509-735-2050
Fax Number :
Provider Business Practice Location Address
First Line : 117 N ELY ST
Second Line :
City : KENNEWICK
State : WA
Zip : 99336-2941
Country : US
Telephone Number : 509-735-2050
Fax Number : 509-735-2288
Authorized Official
Title or Position : PRESIDENT
Name : DR. MAUREEN SUSAN FAHEY
Credential : O.D.
Telephone Number : 509-735-2050
Provider Enumeration Date : 09/02/2006
Last Update Date : 09/24/2009

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