Individual
ANNETTE FEARON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4017 LACONIA AVE, BRONX, NY 10466-4907
(646) 221-4187
Mailing address
4017 LACONIA AVE, BRONX, NY 10466-4907
(646) 221-4187
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
554246-1
NY
Other
Enumeration date
11/16/2007
Last updated
11/16/2007
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