Individual
MS. SUSAN FAIR
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
175 SHERMAN AVE, FIFTH FLOOR, NEW HAVEN, CT 06511-4301
(203) 789-3392
(203) 789-5174
Mailing address
24 WOODWARD AVE, UNIT 61, NEW HAVEN, CT 06512-3659
(203) 467-8440
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000082
CT
Other
Enumeration date
06/12/2006
Last updated
07/08/2007
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