Individual ProviderMichael FamaPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address2500 Nesconset Hwy, Bldg 22b, Stony Brook, NY 11790-2555(631) 751-7988PECOS EnrollmentBased on the most recent information from CMS, provider Michael Fama does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1902345846Provider TypeIndividualFull NameFama, MichaelCredentialDPTGenderMaleSole ProprietorYesEnumeration Date2/13/2017Last Updated2/13/2017Contact InformationPractice LocationPractice Address2500 Nesconset Hwy, Bldg 22b, Stony Brook, NY 11790-2555Phone(631) 751-7988Fax(631) 751-7989Mailing LocationMailing Address2500 Nesconset Hwy, Stony Brook, NY 11790-2555Phone(631) 751-7988Fax(631) 751-7989Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense040934-1New York