Individual
MS. DAWN FAIRLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP,GNP,FNP,CDE
Contact information
Practice address
4771 HYLAN BLVD, STATEN ISLAND, NY 10312-6315
(973) 216-9898
Mailing address
4771 HYLAN BLVD, STATEN ISLAND, NY 10312-6315
(973) 216-9898
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
314022-1
NY
163WM1400X
Nurse Massage Therapist (NMT)
26NN06671900
NJ
174400000X
Specialist
26NN06671900
NJ
174400000X
Specialist
F300719-1
NY
174400000X
Specialist
F340111-1
NY
363LF0000X
Family Nurse Practitioner
Primary
F332587-1
NY
Other
Enumeration date
04/11/2007
Last updated
02/19/2009
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