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General NPI Number Information
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NPI Number | 1639354657
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Entity Type | Individual
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Provider Name | ANGELA A FAIN DC
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Gender | Female
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 01/09/2008
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Provider Practice Location Address
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Address Line | 490 ROUTE 304
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City | NEW CITY
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State | NY
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Zip | 10956-3040
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Country | US
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Telephone | 845-634-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 15 PARK AVE
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City | NEW ROCHELLE
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State | NY
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Zip | 10805-3909
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Country | US
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Telephone | 914-310-6811
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 011522
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License Number State | NY
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