KELLY NICOLE FAHL FRADIN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036162315

License Status

ACTIVE

Business

Title

First Name

KELLY

Middle

NICOLE FAHL

Last Name

FRADIN

Business Name

KELLY NICOLE FAHL FRADIN MD

Original Issue Date

09/09/2022

Effective Date

06/17/2023

Expiration Date

07/31/2026

City

NEW YORK

State

Zip

10075

Ever Disciplined

LastModifiedDate

12/16/2025