Individual
DR. JESSICA FAGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
141 E 55TH ST APT 3D, NEW YORK, NY 10022-4050
(516) 728-5246
Mailing address
28 HOYTS LN, BEDFORD CORNERS, NY 10549-4856
(516) 728-5246
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
022717
NY
Other
Enumeration date
08/27/2018
Last updated
10/20/2021
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