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Individual

MRS. MARY L. FAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ANP-BC, DNP

Contact information

Practice address
300 COMMUNITY DRIVE, MANHASSET, NY 11030
(516) 562-4392
(516) 562-3823
Mailing address
12 RYAN STREET, SYOSSET, NY 11791-2128
(516) 364-2601
(516) 364-2601

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
329012-1
NY
363L00000X
Nurse Practitioner
Primary
F303084-1
NY

Other

Enumeration date
05/04/2012
Last updated
05/04/2012
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