Provider Demographics
NPI:1265487458
Name:MIGOTSKY, FAY J (MD)
Entity Type:Individual
Prefix:
First Name:FAY
Middle Name:J
Last Name:MIGOTSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 117
Mailing Address - Street 2:
Mailing Address - City:RINDGE
Mailing Address - State:NH
Mailing Address - Zip Code:03461-0117
Mailing Address - Country:US
Mailing Address - Phone:603-899-9563
Mailing Address - Fax:603-899-9567
Practice Address - Street 1:145 US ROUTE 202
Practice Address - Street 2:SUITE 207
Practice Address - City:RINDGE
Practice Address - State:NH
Practice Address - Zip Code:03461-7104
Practice Address - Country:US
Practice Address - Phone:603-899-9563
Practice Address - Fax:603-899-9567
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH10185207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30200037Medicaid
B34899Medicare UPIN
B34899Medicare UPIN