Provider Demographics
NPI:1881210540
Name:FAY, YAEL (DNP)
Entity type:Individual
Prefix:DR
First Name:YAEL
Middle Name:
Last Name:FAY
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:DR
Other - First Name:ELLIE
Other - Middle Name:
Other - Last Name:FAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DNP
Mailing Address - Street 1:2441 BLOSSOM LN
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-1522
Mailing Address - Country:US
Mailing Address - Phone:305-785-5370
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-4619
Practice Address - Country:US
Practice Address - Phone:216-444-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS43-557770-021367500000X
MO2020013541367500000X
OH0020499367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered