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NPI Code Detail

MEDICARE: DR. YEVGENIYA FABRIKANT M.D.

MEDICARE: DR. YEVGENIYA FABRIKANT M.D.
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
1208000000XPediatrics Physician79985MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265422315
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. YEVGENIYA FABRIKANT M.D.
Provider Business Mailing Address
First Line : 291 E CENTER ST
Second Line :
City : WEST BRIDGEWATER
State : MA
Zip : 02379-1813
Country : US
Telephone Number : 150-858-4121
Fax Number :
Provider Business Practice Location Address
First Line : 291 E CENTER ST
Second Line :
City : WEST BRIDGEWATER
State : MA
Zip : 02379-1813
Country : US
Telephone Number : 150-858-4121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2005
Last Update Date : 12/15/2011

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