Eric Fanaee MD PC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

ERIC FANAEE MD PC

Practice address

380 Montauk Hwy
West Islip, NY 11795-4403

Phone

(631) 422-5371

Fax

(631) 893-8012

NPI assigned

Sep 27, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eric Fanaee, MDNPI 1184945305

Title

Direct Owner

Phone

(631) 422-5371

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric Fanaee, MD

  • Pain Medicine (Anesthesiology) Physician
  • West Islip, NY
  • NPI 1184945305
  Medicare reassignment Care Compare group NPD Authorized official
• Clarence Kong

  • Emergency Medicine Physician
  • West Islip, NY
  • NPI 1548846140
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1811548142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954403",
            "telephone_number": "631-422-5371",
            "fax_number": "631-893-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954403",
            "telephone_number": "631-422-5371",
            "fax_number": "631-893-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC FANAEE MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-27",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A",
        "authorized_official_last_name": "FANAEE",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "DIRECT OWNER",
        "authorized_official_telephone_number": "631-422-5371",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Empire State Radiology P C
• Deborah Enea, RN,NPP
• William John Jude Engellenner, M.D.
• Denise Engrassia, PA
• Michael A Ercolino, D.C.
• Michael A Esemplare, RPH
• Gabriela Espinal-Santiago, MS., MT-BC, LCAT-LP
• Caitlin Esposito
• Mary Anne Esposito, PT, DPT
• William Charles Etts, DPM

• Interventional Pain Medicine Physician in West Islip, NY
• Providers in West Islip, NY by specialty
• Interventional Pain Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.