MEDICARE: MS. CLAUDIA FABRICANT NP

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
1	363LW0102X	Women's Health Nurse Practitioner	F360364-1	NY
2	363LW0102X	Women's Health Nurse Practitioner	001006	CT

General Provider Information

NPI Number	:	1609852862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CLAUDIA FABRICANT NP

Provider Business Mailing Address
First Line	:	650 W 42ND ST
Second Line	:	#3501
City	:	NEW YORK
State	:	NY
Zip	:	10036-1909
Country	:	US
Telephone Number	:	212-564-3774
Fax Number	:

Provider Business Practice Location Address
First Line	:	650 W 42ND ST
Second Line	:	#3501
City	:	NEW YORK
State	:	NY
Zip	:	10036-1909
Country	:	US
Telephone Number	:	212-564-3774
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2005
Last Update Date	:	07/08/2007

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