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Individual

NICOLE FAIRFAX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
431 56TH ST # 1, WEST NEW YORK, NJ 07093-2133
(646) 905-9558
Mailing address
431 56TH ST # 1, WEST NEW YORK, NJ 07093-2133
(646) 905-9558

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
26NH19618000
NJ

Other

Enumeration date
05/09/2023
Last updated
05/09/2023
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