Healthcare Provider Details

I. General information

NPI: 1932696028
Provider Name (Legal Business Name): FABIANA MARIA KREINES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2018
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 ALMONESSON RD STE 275
DEPTFORD NJ
08096-5243
US

IV. Provider business mailing address

134 BRIDGETON PIKE STE C
MULLICA HILL NJ
08062-2616
US

V. Phone/Fax

Practice location:
  • Phone: 856-641-8680
  • Fax: 856-641-8679
Mailing address:
  • Phone: 856-507-2783
  • Fax: 856-221-4138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number25MA12697900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: