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Contact Information

GEORGE G FAIREY, MD
1227 MAIN ST STE 202
PORT JEFFERSON, NY11777-2227
 Phone: 631-689-5155
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for GEORGE G FAIREY · (Male)

NPI # 1780857276
Status Active
Credentials MD
Entity Individual
Enumeration date 04/07/2008
Last updated 09/10/2008 - About 18 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 129972
  • NY Medicaid 00509146
Hospital affiliation(s)
  • JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON - (Acute Care)
    75 NORTH COUNTRY ROAD
    PORT JEFFERSON, NY 11777
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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