Individual
DAWN MARIE FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
750 E HENRIETTA RD, ROCHESTER, NY 14623-1406
(585) 775-6673
Mailing address
1950 E HENRIETTA RD, ROCHESTER, NY 14623-3921
(585) 775-6673
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
258797
NY
Other
Enumeration date
07/27/2017
Last updated
03/17/2018
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