{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "JILL FABIAN RN PLLC",
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"FirstLineMailingAddress": "3732 75TH ST STE 2",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JACKSON HEIGHTS",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11372-6406",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "718-938-1508",
"MailingAddressFaxNumber": "646-224-9478",
"FirstLinePracticeLocationAddress": "3732 75TH ST STE 2",
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"PracticeLocationAddressCityName": "JACKSON HEIGHTS",
"PracticeLocationAddressStateName": "NY",
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"PracticeLocationAddressTelephoneNumber": "718-938-1508",
"PracticeLocationAddressFaxNumber": "646-224-9478",
"EnumerationDate": "09/21/2017",
"LastUpdateDate": "07/21/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FABIAN",
"AuthorizedOfficialFirstName": "JILL",
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"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "718-938-1508",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Home Health Agency",
"LicenseNumber": "364206-1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}