Provider Demographics
NPI:1982981288
Name:ESTERA, FABIOLA
Entity Type:Individual
Prefix:MS
First Name:FABIOLA
Middle Name:
Last Name:ESTERA
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 1:110 VERNON AVE
Mailing Address - Street 2:APT 2L
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10553-1800
Mailing Address - Country:US
Mailing Address - Phone:401-225-6392
Mailing Address - Fax:
Practice Address - Street 1:110 VERNON AVENUE
Practice Address - Street 2:APT 2L
Practice Address - City:MT. VERNON
Practice Address - State:NY
Practice Address - Zip Code:10553
Practice Address - Country:US
Practice Address - Phone:401-225-6392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator