Fay, Jerome Allan
Fay, Jerome Allan is an individual health care provider with primary practice located at 1560 University Ave W , Saint Paul MN 55104-3908. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Fay, Jerome Allan can be contacted via phone (651) 646-8889.Contact Information
Primary practice address
1560 University Ave W
Saint Paul MN 55104-3908
Phone: (651) 646-8889
Fax: (651) 646-3761
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2684 | Minnesota |
Profile Details
| NPI number | 1659335289 |
|---|---|
| LBN Legal business name | Fay, Jerome Allan |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 12th, 2006 |
| Last updated | Oct 24th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659335289 | NPPES |
| Minnesota | Other | 2201029 | MEDICA |
| Minnesota | Other | 140179 | MEDICA |
| Minnesota | Other | 32F04FA | MEDICA |
| Minnesota | Other | MEDICAL ASSISTANCE | MEDICA |
| Minnesota | Other | 40288 | MEDICA |
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