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Contact Information

MACKENNA G FAGAN
4362 GRIDER RD
ELMA, NY14059
 Phone: 716-652-3000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapy Assistant

224Z00000X
Indicates primary specialty

NPI Profile & details for MACKENNA G FAGAN · (Female)

NPI Number 1396415857
Status Active
Credentials
Entity Individual
Enumeration date 09/16/2021
Last updated 09/16/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 008973
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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