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General NPI Number Information
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NPI Number | 1245548411
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Entity Type | Individual
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Provider Name | RONALD FABELLO RPT
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Gender | Male
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Dates
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Enumeration Date | 09/21/2010
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Last Update Date | 10/16/2020
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Provider Practice Location Address
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Address Line | 1865 AMSTERDAM AVE LOWR LEVEL
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City | NEW YORK
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State | NY
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Zip | 10031-1716
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Country | US
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Telephone | 516-433-4570
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Fax | 516-433-4578
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Provider Business Mailing Address
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Address Line | 111 W OLD COUNTRY RD UNIT 1
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City | HICKSVILLE
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State | NY
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Zip | 11801-4036
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Country | US
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Telephone | 516-433-4570
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Fax | 516-433-4578
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 028142
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License Number State | NY
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