Individual
MELBA FAWCETT-SANDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2045 INDEPENDENCE DR, NEW WINDSOR, NY 12553-4932
(914) 261-7059
Mailing address
2045 INDEPENDENCE DR, NEW WINDSOR, NY 12553-4932
(914) 261-7059
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
632942951
NY
Other
Enumeration date
03/10/2014
Last updated
03/10/2014
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