Provider Demographics
NPI:1629530589
Name:FAIRFULL, AUBREE MEGAN (MD)
Entity type:Individual
Prefix:
First Name:AUBREE
Middle Name:MEGAN
Last Name:FAIRFULL
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Gender:F
Credentials:MD
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Mailing Address - Street 1:601 ELMWOOD AVENUE BOX 664
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-3273
Mailing Address - Fax:585-442-2949
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-4725
Practice Address - Country:US
Practice Address - Phone:585-275-3273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2024-10-23
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Provider Licenses
StateLicense IDTaxonomies
NY3290512081P0004X, 2081P0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine