Provider Demographics
NPI:1720711336
Name:FAIL, PAULINE FAY II
Entity type:Individual
Prefix:MISS
First Name:PAULINE
Middle Name:FAY
Last Name:FAIL
Suffix:II
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26154 REGENCY CLUB DR APT 4
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48089-6249
Mailing Address - Country:US
Mailing Address - Phone:313-622-6675
Mailing Address - Fax:
Practice Address - Street 1:26154 REGENCY CLUB DR APT 4
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48089-6249
Practice Address - Country:US
Practice Address - Phone:313-622-6675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-01
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health