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NPI Code Detail

MEDICARE: FREDRIC FABIANO MD

MEDICARE: FREDRIC FABIANO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician154912NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2112923650OTHERNYRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679573414
Entity Type Code : Individual
Provider Name (Legal Business Name) : FREDRIC FABIANO MD
Provider Business Mailing Address
First Line : 3998 FAIR RIDGE DR
Second Line : SUITE 300
City : FAIRFAX
State : VA
Zip : 22033-2921
Country : US
Telephone Number : 703-295-9360
Fax Number : 703-766-9725
Provider Business Practice Location Address
First Line : 221 JERICHO TPKE
Second Line : ANESTHESIA DEPARTMENT
City : SYOSSET
State : NY
Zip : 11791-4515
Country : US
Telephone Number : 516-496-6558
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2005
Last Update Date : 04/03/2015

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