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General NPI Number Information
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NPI Number | 1114436128
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Entity Type | Organization
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Legal Business Name | JILL FABIAN RN PLLC
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Dates
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Enumeration Date | 09/21/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3732 75TH ST STE 2
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6406
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Country | US
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Telephone | 718-938-1508
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Fax | 646-224-9478
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Provider Business Mailing Address
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Address Line | 3732 75TH ST STE 2
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6406
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Country | US
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Telephone | 718-938-1508
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Fax | 646-224-9478
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JILL FABIAN
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Credential | RN
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Telephone | 718-938-1508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 364206-1
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License Number State | NY
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