Individual
MS. ALVINA FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
701 HEWITT LN APT 4, NEW WINDSOR, NY 12553-5444
(845) 562-2077
Mailing address
701 HEWITT LN APT 4, NEW WINDSOR, NY 12553-5444
(845) 562-2077
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
128466-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008644846
—
NY
Enumeration date
09/04/2008
Last updated
09/04/2008
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