Provider Demographics
NPI:1942286844
Name:FAY, DAVID E (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:FAY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:60 MAPLE RD
Mailing Address - Street 2:STE 1
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-2917
Mailing Address - Country:US
Mailing Address - Phone:716-626-5250
Mailing Address - Fax:716-626-5316
Practice Address - Street 1:60 MAPLE RD
Practice Address - Street 2:STE 1
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-2917
Practice Address - Country:US
Practice Address - Phone:716-626-5250
Practice Address - Fax:716-626-5316
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2007-10-02
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Provider Licenses
StateLicense IDTaxonomies
NY162349207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY040426003302OtherFIDELIS
NY153007BTOtherPREFERRED CARE
NY00010053801OtherUNIVERA
NY01089032Medicaid
NY2309527OtherINDEPENDENT HEALTH
NY2400256OtherGHI
NY4614608OtherAETNA
NY000510422004OtherBLUE CROSS OF WNY
NY2400256OtherGHI
NY000510422004OtherBLUE CROSS OF WNY