Provider Demographics
NPI:1437184504
Name:FABILA, JOCELYN E (MD)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:E
Last Name:FABILA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 ATLANTIC CITY BLVD
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08721-1229
Mailing Address - Country:US
Mailing Address - Phone:732-349-1977
Mailing Address - Fax:732-349-0841
Practice Address - Street 1:160 ATLANTIC CITY BLVD
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08721-1229
Practice Address - Country:US
Practice Address - Phone:732-349-1977
Practice Address - Fax:732-349-0841
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA057399002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ527976C2DOtherMEDICARE PROVIDER NUMBER
NJ6337201Medicaid
NJ527976C2DOtherMEDICARE PROVIDER NUMBER