Individual provider Active NPI

Evelyn Fabian

  • Social Worker
  • Clifton, NJ
National Provider Identifier
1720459217
Registry record updated Oct 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
44SL05949200 Issued in NJ
Practice address
777 Bloomfield Ave
Clifton, NJ 07012-1242
Phone
(973) 594-0125
NPI assigned
Oct 9, 2015
Last updated
Oct 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 44SL05949200 NJ Primary

Addresses

Primary practice location

777 Bloomfield Ave
Clifton, NJ 07012-1242

Mailing address

211 Brighton Ave
Apt 2
Kearny, NJ 07032-2134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
44SL05949200NJMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444348800000",
    "number": "1720459217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 BRIGHTON AVE",
            "address_2": "APT 2",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070322134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BLOOMFIELD AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121242",
            "telephone_number": "973-594-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABIAN",
        "first_name": "EVELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-09",
        "last_updated": "2015-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL05949200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.