Individual
MARIA FABIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
554 FORT WASHINGTON AVE, NEW YORK, NY 10033-2003
(212) 740-5157
Mailing address
79 FAIRVIEW AVE, BOGOTA, NJ 07603-1807
(201) 457-1809
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
003372-1
NY
Other
Enumeration date
10/01/2009
Last updated
10/01/2009
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