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General NPI Number Information
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NPI Number | 1922141001
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Entity Type | Individual
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Provider Name | JILL FABRI MS, RD, LDN
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Gender | Female
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 100 LINCOLN AVE
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City | CARBONDALE
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State | PA
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Zip | 18407-2116
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Country | US
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Telephone | 570-281-1024
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Fax | 570-281-5392
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Provider Business Mailing Address
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Address Line | 625 MARY JO DR
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City | JESSUP
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State | PA
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Zip | 18434-1965
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Country | US
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Telephone | 570-383-6367
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DN001665
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License Number State | PA
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