Individual ProviderElizabeth FairlessLicensed Practical NurseNursing Service ProvidersPractice Address2 Henry Pl, Patchogue, NY 11772-1838(631) 538-5087PECOS EnrollmentBased on the most recent information from CMS, provider Elizabeth Fairless does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1689270613Provider TypeIndividualFull NameFairless, ElizabethCredentialLPNGenderFemaleSole ProprietorYesEnumeration Date12/6/2020Last Updated12/6/2020Contact InformationPractice LocationPractice Address2 Henry Pl, Patchogue, NY 11772-1838Phone(631) 538-5087FaxUnlisted FaxMailing LocationMailing Address2 Henry Pl, Patchogue, NY 11772-1838Phone(631) 538-5087FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode164W00000XPrimaryDescriptionLicensed Practical NurseNursing Service ProvidersLicense338914New York