Basic Information
Provider Information
NPI: 1790168904
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FAIN
FirstName: EKATERINA
MiddleName: ALIMOVA
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 ROSE STREET ANESTHESIOLOGY
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405360293
CountryCode: US
TelephoneNumber: 8592180069
FaxNumber: 8593231080
Practice Location
Address1: 800 ROSE STREET ANESTHESIOLOGY
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405360293
CountryCode: US
TelephoneNumber: 8592180069
FaxNumber: 8593231080
Other Information
ProviderEnumerationDate: 07/07/2015
LastUpdateDate: 06/07/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XR3766KYN Allopathic & Osteopathic PhysiciansAnesthesiology 
207L00000X52245KYY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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