Individual
LAUREN FARGIONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
143 JOHNSON AVE, SAYVILLE, NY 11782-1136
(631) 334-2255
Mailing address
143 JOHNSON AVE, SAYVILLE, NY 11782-1136
(631) 334-2255
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
322777091
NY
171W00000X
Contractor
Primary
322778091
NY
171W00000X
Contractor
322779091
NY
171W00000X
Contractor
322893091
NY
Other
Enumeration date
08/22/2013
Last updated
08/22/2013
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