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NPI Code Detail

MEDICARE: FABIOLA DUVERGER

MEDICARE: FABIOLA DUVERGER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1003355082
Entity Type Code : Individual
Provider Name (Legal Business Name) : FABIOLA DUVERGER
Provider Business Mailing Address
First Line : 945 RIVER AVE STE 201
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-5675
Country : US
Telephone Number : 732-833-3723
Fax Number :
Provider Business Practice Location Address
First Line : 945 RIVER AVE STE 201
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-5675
Country : US
Telephone Number : 732-833-3723
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2017
Last Update Date : 02/26/2019

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Directions to “ FABIOLA DUVERGER ” Practice Location

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