Individual
FREDRIC FABIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
221 JERICHO TPKE, ANESTHESIA DEPARTMENT, SYOSSET, NY 11791-4515
(516) 496-6558
Mailing address
3998 FAIR RIDGE DR, SUITE 300, FAIRFAX, VA 22033-2921
(703) 295-9360
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
154912
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00913057
—
NY
01
—
112923650
RAILROAD MEDICARE
NY
Enumeration date
07/22/2005
Last updated
04/03/2015
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