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NPI Code Detail

MEDICARE: MR. RYAN PABIS

MEDICARE: MR. RYAN PABIS
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
1101YM0800XMental Health CounselorP00245NY

General Provider Information

NPI Number : 1306206685
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RYAN PABIS
Provider Business Mailing Address
First Line : 1149 SULLIVAN ST
Second Line :
City : ELMIRA
State : NY
Zip : 14901-1670
Country : US
Telephone Number : 607-733-7661
Fax Number :
Provider Business Practice Location Address
First Line : 1149 SULLIVAN ST
Second Line :
City : ELMIRA
State : NY
Zip : 14901-1670
Country : US
Telephone Number : 607-733-7661
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2016
Last Update Date : 03/01/2016

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