Individual
MRS. MARY FAIRE LEDERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6 WIERK AVE, LIBERTY, NY 12754-2117
(845) 292-5618
Mailing address
465 CYPERT RD, WOODBOURNE, NY 12788-5379
(845) 434-7056
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
383133-1
NY
Other
Enumeration date
10/28/2010
Last updated
10/28/2010
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