Individual
ELIZABETH FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12 BANK ST STE 201, SUMMIT, NJ 07901-3661
(908) 376-6550
Mailing address
12 BANK ST STE 201, SUMMIT, NJ 07901-3661
(908) 376-6550
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MA074625
NJ
Other
Enumeration date
02/06/2006
Last updated
05/01/2013
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