Healthcare Provider Details

I. General information

NPI: 1285098491
Provider Name (Legal Business Name): ABBY L VRABLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2016
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3624 W MARKET ST STE 101
FAIRLAWN OH
44333-4510
US

IV. Provider business mailing address

3624 W MARKET ST STE 101
FAIRLAWN OH
44333-4510
US

V. Phone/Fax

Practice location:
  • Phone: 330-665-0555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number34.014891
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: