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MR. DANIEL ROBERT FAWCETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP STUDENT

Contact information

Practice address
400 S ORANGE AVE, SOUTH ORANGE, NJ 07079-2697
(973) 761-9000
Mailing address
1756 RICHMOND AVE, STATEN ISLAND, NY 10314-3902
(718) 477-5670

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F407438-01
NY

Other

Enumeration date
10/20/2023
Last updated
08/26/2025
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