Provider Demographics
NPI:1164411567
Name:CHAHFE, FAYEZ (MD)
Entity Type:Individual
Prefix:
First Name:FAYEZ
Middle Name:
Last Name:CHAHFE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 GENESEE ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-5829
Mailing Address - Country:US
Mailing Address - Phone:315-792-4623
Mailing Address - Fax:315-792-6901
Practice Address - Street 1:2206 GENESEE ST
Practice Address - Street 2:SUITE 301
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-5829
Practice Address - Country:US
Practice Address - Phone:315-792-4623
Practice Address - Fax:315-792-6901
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197706-1207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01534303Medicaid
NYBB6934Medicare ID - Type UnspecifiedMEDICARE
NY01534303Medicaid