Provider Demographics
NPI:1114678547
Name:FIFIELD, JOAN
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:FIFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:
Other - Last Name:SELLS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:210 CLIFTON SPRINGS PROFESSIONAL PARK
Mailing Address - Street 2:
Mailing Address - City:CLIFTON SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:14432-1041
Mailing Address - Country:US
Mailing Address - Phone:315-906-0051
Mailing Address - Fax:
Practice Address - Street 1:210 CLIFTON SPRINGS PROFESSIONAL PARK
Practice Address - Street 2:
Practice Address - City:CLIFTON SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:14432-1041
Practice Address - Country:US
Practice Address - Phone:315-906-0051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator