Provider Demographics
NPI:1275726226
Name:FAHY, MICHAEL PATRICK (ATC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:PATRICK
Last Name:FAHY
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4245 EAST AVE
Mailing Address - Street 2:NAZARETH COLLEGE
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-3703
Mailing Address - Country:US
Mailing Address - Phone:585-389-2838
Mailing Address - Fax:585-389-2839
Practice Address - Street 1:4245 EAST AVE
Practice Address - Street 2:NAZARETH COLLEGE
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-3703
Practice Address - Country:US
Practice Address - Phone:585-389-2838
Practice Address - Fax:585-389-2839
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer