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Individual

ABBYGAEL FRASER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
91 FIDDLERS LN, LATHAM, NY 12110-5343
(785) 851-8591
Mailing address
91 FIDDLERS LN, LATHAM, NY 12110-5343
(518) 785-8591

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
739595
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03052893
NY
Enumeration date
08/16/2023
Last updated
08/16/2023
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