Individual
MR. ANDREW JAMES FAIRLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRPA
Contact information
Practice address
96 MOBILE AVE, STATEN ISLAND, NY 10306-2128
(347) 756-0787
Mailing address
96 MOBILE AVE, STATEN ISLAND, NY 10306-2128
(347) 756-0787
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CRPA-P-4690
NY
Other
Enumeration date
01/11/2021
Last updated
01/11/2021
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