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General NPI Number Information
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NPI Number | 1477984953
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Entity Type | Individual
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Provider Name | KRISTINA VICTOR FAIR APN-C
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Gender | Female
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Dates
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Enumeration Date | 12/09/2013
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 1600 SAINT GEORGES AVE SUITE 202
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City | RAHWAY
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State | NJ
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Zip | 07065-2764
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Country | US
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Telephone | 732-499-0111
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Fax |
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Provider Business Mailing Address
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Address Line | 2903 VANTAGE CT
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City | DENVILLE
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State | NJ
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Zip | 07834-3452
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Country | US
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Telephone | 973-343-7340
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 26NJ00494500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 26NJ00494500
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License Number State | NJ
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