Healthcare Provider Details

I. General information

NPI: 1841113347
Provider Name (Legal Business Name): FABIENNE DOMINIQUE GAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 CAMP AVE
TRENTON NJ
08610-4802
US

IV. Provider business mailing address

20 CAMP AVE
TRENTON NJ
08610-4802
US

V. Phone/Fax

Practice location:
  • Phone: 754-249-3751
  • Fax: 754-249-3751
Mailing address:
  • Phone: 754-249-3751
  • Fax: 754-249-3751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberN14661
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: