Basic Information
Provider Information
NPI: 1669414397
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SABRY
FirstName: FADY
MiddleName: FAYEZ
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 732 SUMMITVIEW AVE # 621
Address2:  
City: YAKIMA
State: WA
PostalCode: 989023032
CountryCode: US
TelephoneNumber: 5095733448
FaxNumber: 5095744481
Practice Location
Address1: 111 S 11TH AVE
Address2: SUITE 321
City: YAKIMA
State: WA
PostalCode: 989023242
CountryCode: US
TelephoneNumber: 5095774600
FaxNumber: 5095774619
Other Information
ProviderEnumerationDate: 06/10/2006
LastUpdateDate: 10/10/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD00046541WAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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