Clark Fairfax, Debora

Clark Fairfax, Debora is an sole proprietor health care provider with primary practice located at 164 W 121St St , New York NY 10027-6324. She recently has only one registered license in Other Service Providers / Contractor, which is considered as her primary health care specialty. Clark Fairfax, Debora can be contacted via phone (212) 866-2964.

Contact Information

Primary practice address
164 W 121St St New York NY 10027-6324
Phone: (212) 866-2964
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Contractor 171W00000X New York

Profile Details

NPI number 1821351347
LBN Legal business name Clark Fairfax, Debora
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 19th, 2012
Last updated Jun 19th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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