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1821351347
DEBORA CLARK FAIRFAX
NEW YORK, NY
NPI
1821351347
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171W00000X Contractor
Enumeration Date
2012-06-19
Last Update Date
2012-06-19
Business Address
-- DEBORA CLARK FAIRFAX
164 W 121ST ST
NEW YORK, NY 10027-6324
Phone number: 212-866-2964
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Mailing Address
-- DEBORA CLARK FAIRFAX
164 W 121ST ST
NEW YORK, NY 10027-6324
Phone number: 212-866-2964
Copy
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