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George G. Fairey Md
Adult Mental Health Clinic/Center in Stony Brook, New York
NPI 1073603734

George G. Fairey Md is an Adult Mental Health Clinic/Center based in Stony Brook, NY and is specialized in Adult Mental Health. George G. Fairey Md practices in Stony Brook, NY. The NPI Number for George G. Fairey Md is 1073603734 and holds a License No. 129972 (New York).

The current practice location address for George G. Fairey Md is 1212 N Country Rd Ste 2A, Stony Brook, NY and can be reached out via phone at 631-689-5155.

Location: 1212 N Country Rd Ste 2A, Stony Brook, NY, 11790-1919
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1073603734
Provider Name
George G. Fairey Md
Credential
Provider Entity Type
Organization
Address
1212 N Country Rd Ste 2A, Stony Brook, NY, 11790-1919
Phone Number
631-689-5155
Fax Number
Provider Enumeration Date
10/13/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00509146 05 NY
institution
Provider Business Practice Location Address Details
Address
1212 N Country Rd Ste 2A
City
Stony Brook
State
New York
Zip
11790-1919
Phone Number
631-689-5155
Fax Number
person
Provider Business Mailing Address Details
Address
1212 N Country Rd Ste 2A
City
Stony Brook
State
New York
Zip
11790-1919
Phone Number
631-689-5155
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
129972 (New York)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
261QM0850X
License No.
129972 (New York)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
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