Provider Demographics
NPI:1881878239
Name:FAY, BARRY (DC)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:
Last Name:FAY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4197 NW 88TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6040
Mailing Address - Country:US
Mailing Address - Phone:954-748-3700
Mailing Address - Fax:954-748-6235
Practice Address - Street 1:4197 NW 88TH AVE
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6040
Practice Address - Country:US
Practice Address - Phone:954-748-3700
Practice Address - Fax:954-748-6235
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8947111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor