Fabiola Civil
Individual provider Active NPI Licensed Vocational Nurse · East Patchogue, NY
NPI 1417865130 · NPPES record last updated Sep 1, 2026
Key facts
- NPI
- 1417865130
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Vocational Nurse 164X00000X
- License
- 335503-01 (NY)
- Practice address
- 29 Myrtle LN
East Patchogue, NY 11772-5722 - Phone
- (347) 233-9610
- NPI assigned
- Sep 1, 2026
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse |
164X00000X | 335503-01 | NY | Yes |
Addresses
Primary practice location
29 Myrtle LN
East Patchogue, NY 11772-5722
Mailing address
29 Myrtle LN
East Patchogue, NY 11772-5722
Other providers in East Patchogue, NY
- Pierre Wisly Charles
- Robert M Chernaik
- Peter Chiu
- Christopher Joubert DDS PC
- George Ciresi III
- Erin M Clancy
- CM Blaine MD PLLC
- Cogent Medical Care PC
- Richard E Collins
- Brooks Comeno
All providers in East Patchogue, NY · Licensed Vocational Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.