Individual
KATIE FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2811 QUEENS PLZ N FL 5, LONG ISLAND CITY, NY 11101-4172
(718) 391-8300
Mailing address
972 80TH ST, BROOKLYN, NY 11228-2618
(347) 452-3711
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
708978
NY
Other
Enumeration date
03/19/2025
Last updated
03/19/2025
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