Healthcare Provider Details

I. General information

NPI: 1982898508
Provider Name (Legal Business Name): KRISTIN LIZABETH FABBIO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 DEKALB AVE
BROOKLYN NY
11201-5493
US

IV. Provider business mailing address

121 DEKALB AVE
BROOKLYN NY
11201-5493
US

V. Phone/Fax

Practice location:
  • Phone: 718-250-8657
  • Fax: 718-682-3973
Mailing address:
  • Phone: 718-250-8657
  • Fax: 718-682-3973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number052131-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRP442142
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP442142
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS44505
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number052131-1IC
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPS44505
License Number StateFL
# 7
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number052131
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: