Individual
EDWARD FAIRCHILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CO, CPED
Contact information
Practice address
477 STATE ST, COLONIAL PLAZA, BINGHAMTON, NY 13901
(607) 348-0343
(607) 348-0347
Mailing address
477 STATE ST, COLONIAL PLAZA, BINGHAMTON, NY 13901
(607) 348-0343
(607) 348-0347
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
CO003702
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02408313
—
NY
Enumeration date
08/14/2006
Last updated
07/08/2007
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