Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 25MA06842800 | NJ |
N | 207VG0400X | Gynecologist | MA68428 | NJ |
NPI | 1275502072 |
---|---|
Provider Name | Christopher J Fabricant |
First Address | Shrewsbury, NJ 07702-4151 |
Second Address | Shrewsbury, NJ 07702-4151 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2006 |
Last Update Date | 03/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8813302 | (05) | NJ |
H56039 | (02) | NJ |