Provider Demographics
NPI:1386013217
Name:FABRIS-COON, DEBORAH
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:
Last Name:FABRIS-COON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PENN YAN
Mailing Address - State:NY
Mailing Address - Zip Code:14527-1051
Mailing Address - Country:US
Mailing Address - Phone:315-536-7447
Mailing Address - Fax:315-536-3281
Practice Address - Street 1:235 NORTH AVE
Practice Address - Street 2:
Practice Address - City:PENN YAN
Practice Address - State:NY
Practice Address - Zip Code:14527-1051
Practice Address - Country:US
Practice Address - Phone:315-536-7447
Practice Address - Fax:315-536-3281
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist