Provider Demographics
NPI:1205069259
Name:FAHY, JOHN PATRICK (DPT)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PATRICK
Last Name:FAHY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:612 CORPORATE WAY
Mailing Address - Street 2:SUITE 7
Mailing Address - City:VALLEY COTTAGE
Mailing Address - State:NY
Mailing Address - Zip Code:10989-2021
Mailing Address - Country:US
Mailing Address - Phone:845-268-7800
Mailing Address - Fax:845-268-5037
Practice Address - Street 1:612 CORPORATE WAY
Practice Address - Street 2:SUITE 7
Practice Address - City:VALLEY COTTAGE
Practice Address - State:NY
Practice Address - Zip Code:10989-2021
Practice Address - Country:US
Practice Address - Phone:845-268-7800
Practice Address - Fax:845-268-5037
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030562-12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic