Provider Demographics
NPI:1245548411
Name:FABELLO, RONALD (RPT)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:
Last Name:FABELLO
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 W OLD COUNTRY RD UNIT 1
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-4036
Mailing Address - Country:US
Mailing Address - Phone:516-433-4570
Mailing Address - Fax:516-433-4578
Practice Address - Street 1:1865 AMSTERDAM AVE LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-1716
Practice Address - Country:US
Practice Address - Phone:516-433-4570
Practice Address - Fax:516-433-4578
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-21
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0281422251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports