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General NPI Number Information
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NPI Number | 1811659477
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Entity Type | Individual
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Provider Name | FABIEN PAUL PA-C
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Gender | Male
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Dates
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Enumeration Date | 10/12/2021
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 231 WASHINGTON ST
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City | HOBOKEN
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State | NJ
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Zip | 07030-7221
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Country | US
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Telephone | 201-754-1006
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Fax | 201-754-1005
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Provider Business Mailing Address
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Address Line | 1 DIAMOND HILL RD
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City | BERKELEY HEIGHTS
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State | NJ
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Zip | 07922-2104
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Country | US
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Telephone | 908-273-4300
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 25MP00856400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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