Provider Demographics
NPI:1316708936
Name:FAIRLEY, STEVEN JR
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:FAIRLEY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 MAN MAR DR UNIT 4
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02762-2272
Mailing Address - Country:US
Mailing Address - Phone:508-780-0031
Mailing Address - Fax:
Practice Address - Street 1:51 MAN MAR DR UNIT 4
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:MA
Practice Address - Zip Code:02762-2272
Practice Address - Country:US
Practice Address - Phone:508-780-0031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator