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General NPI Number Information
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NPI Number | 1932424884
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Entity Type | Organization
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Legal Business Name | PRECISION SURGICAL ASSISTING LLC
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Dates
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Enumeration Date | 04/05/2010
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Last Update Date | 04/05/2010
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Provider Practice Location Address
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Address Line | 16635 17TH RD
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City | WHITESTONE
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State | NY
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Zip | 11357-3308
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Country | US
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Telephone | 917-548-6389
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Fax |
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Provider Business Mailing Address
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Address Line | 16635 17TH RD
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City | WHITESTONE
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State | NY
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Zip | 11357-3308
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Country | US
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Telephone | 917-548-6389
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH FABLE
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Credential | P.A.
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Telephone | 917-548-6389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 008446-1
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License Number State | NY
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