Fairfax Acne & Dermatology Services, PC
NPI #1245947332 in East Providence, Rhode Island
Provider Information
- NPI Number
- 1245947332
- Entity Type
- Organization
- Organization Name
- Fairfax Acne & Dermatology Services, PC
- Primary Specialty
- Nurse Practitioner
- Enumeration Date
- Oct 31, 2022
- Last Updated
- Oct 31, 2022
Practice Location
- Address
- 1275 WAMPANOAG TRAIL
- Address 2
- STE. 6
- City
- East Providence
- State
- Rhode Island
- ZIP Code
- 02915-1217
- Phone
- (508) 404-4853
Authorized Official
- Name
- DIANA L FAIRFAX, DCNP
- Title
- OWNER
- Phone
- (508) 404-3853
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner |
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