Individual
MARY FAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
319 BEECH ST, TEEN CLINIC, HOLYOKE, MA 01040-3968
(413) 534-2033
Mailing address
66 ROE AVE, NORTHAMPTON, MA 01060-1636
(413) 584-1732
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
109181
MA
Other
Enumeration date
05/10/2007
Last updated
12/18/2014
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