Provider Demographics
NPI:1093495848
Name:AIT FARES, FATIMA (RN)
Entity Type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:AIT FARES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 QUINCY AVE APT 111
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-6733
Mailing Address - Country:US
Mailing Address - Phone:617-982-9444
Mailing Address - Fax:
Practice Address - Street 1:135 QUINCY AVE APT 111
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-6733
Practice Address - Country:US
Practice Address - Phone:617-982-9444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2370053163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health