Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 249537 | NY |
NPI | 1043450133 |
---|---|
Provider Name | Dr. Michelle Therese Fabian |
First Address | New York, NY 10029-6501 |
Second Address | New York, NY 10128-3903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2009 |
Last Update Date | 26/07/2011 |