Provider Demographics
NPI:1013946771
Name:FABISZEWSKA, EWA (MD)
Entity Type:Individual
Prefix:DR
First Name:EWA
Middle Name:
Last Name:FABISZEWSKA
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 1:7927 FAIRFIELD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-3406
Mailing Address - Country:US
Mailing Address - Phone:610-299-5959
Mailing Address - Fax:267-343-8433
Practice Address - Street 1:7927 FAIRFIELD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-3406
Practice Address - Country:US
Practice Address - Phone:610-299-5959
Practice Address - Fax:267-343-8433
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD051811L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0072863020002Medicaid
PAF75104Medicare UPIN