Organization · Type 2 NPI
Fayetteville Family Physician, PLLC
Primary Care Clinic/Center · Fayetteville, NY
NPI number
1164708707
Active
Practice location
6834 E Genesee St
Fayetteville, NY 13066-1021
Fax (347) 772-3132
Mailing address
6834 East Genesee Street
Fayetteville, NY 13066
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Clinic/Center Primary | 261QP2300X | 2462581 (NY) |
Primary Care Clinic/Center: Definition to come...
2 other providers at this address
About NPI 1164708707
Fayetteville Family Physician, PLLC's National Provider Identifier is 1164708707, issued on Oct 27, 2011. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Fayetteville, NY. The record was last updated on Oct 27, 2011.