Individual
MONIQUE MARTINA FAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
85 HERRICK ST, BEVERLY, MA 01915-1790
(978) 816-3700
Mailing address
PROVIDER ENROLLMENT 41 MALL ROAD, BURLINGTON, MA 01805-0001
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
038713-23
NH
367500000X
Certified Registered Nurse Anesthetist
18938
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
RN207882
MA
Other
Enumeration date
09/16/2006
Last updated
02/07/2024
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