MRS. Nina Michelle Fagan
NPI #1124389036 in Manorville, New York
Provider Information
- NPI Number
- 1124389036
- Entity Type
- Individual
- Name
- MRS. Nina Michelle Fagan
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist
- Enumeration Date
- Jun 6, 2012
- Last Updated
- Jun 6, 2012
Practice Location
- Address
- 42 OCEANVIEW BLVD
- City
- Manorville
- State
- New York
- ZIP Code
- 11949-2956
- Phone
- (516) 356-3716
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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