Individual
CAROL FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1819 BERGEN ST, BROOKLYN, NY 11233-4513
(718) 221-4500
(718) 613-3159
Mailing address
1819 BERGEN ST, BROOKLYN, NY 11233-4513
(718) 221-4500
(718) 613-3159
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
038389
NY
Other
Enumeration date
11/10/2015
Last updated
11/10/2015
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