Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Petagay P. Fairclough

Individual provider Family Nurse Practitioner · NPI 1710675566

Petagay P. Fairclough is a Nurse Practitioner in Poughkeepsie, New York. Qualified in 2022, 4 years ago. Practices with Nuvance Health Medical Practice PC, a 575-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2023
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Practice location Address checks out

45 Reade Pl
Poughkeepsie, NY 12601-3947
Phone: (845) 454-8500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence F351722-01 (NY)

Record details

NPI number1710675566
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 28, 2023
Last updated in NPPESApril 28, 2023
Certification dateApril 28, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Nuvance Health Medical Practice Pc — 575 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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