Individual
JASON DANIEL FABIANSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.P.A.-C.
Contact information
Practice address
3810 TAYLOR RD, ORCHARD PARK, NY 14127-2232
(716) 854-5700
(716) 677-6407
Mailing address
700 MICHIGAN AVE, BUFFALO, NY 14203-1536
(716) 854-5700
(716) 854-5800
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
006393-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000570176001
BLUE CROSS
NY
05
—
01864846
—
NY
01
—
9512181
INDEPENDENT HEALTH
NY
Enumeration date
06/07/2006
Last updated
04/14/2021
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