National Provider Identifier
Matthew Ryan Fabian
Matthew Ryan Fabian is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Ithaca, NY and a listed phone number of (607) 274-3011.
Profile Overview
- NPI
- 1235987579
- Provider Type
- Individual
- Primary Specialty
- Student in an Organized Health Care Education/Training Program
- Enumeration Date
- May 10, 2024
- Last Updated
- January 27, 2025
Practice Location
- 953 Danby Road
- Ithaca, NY 14850
Phone: (607) 274-3011
Mailing Address
- 503 Douglas Avenue
- Toronto, Ontario 516
- CA
Specialties
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1235987579
- Entity Type
- Individual
- Last Name
- Fabian
- First Name
- Matthew
- Middle Name
- Ryan
- Name Prefix
- Mr.
- Mailing Street Address
- 503 Douglas Avenue
- Mailing City
- Toronto
- Mailing State
- Ontario
- Mailing ZIP Code
- 516
- Mailing Country
- CA
- Practice Street Address
- 953 Danby Road
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850
- Practice Country
- US
- Practice Phone
- (607) 274-3011
- Enumeration Date
- May 10, 2024
- Last Updated
- January 27, 2025
- Deactivation Date
- January 10, 2025
- Reactivation Date
- January 27, 2025
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Student in an Organized Health Care Education/Training Program (390200000X)