Basic Information
| Provider Information | |||||||||
| NPI: | 1467960567 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FABRIZIO | ||||||||
| FirstName: | KAYLA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 14890 | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122124890 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5185255634 | ||||||||
| FaxNumber: | 5186494094 | ||||||||
| Practice Location | |||||||||
| Address1: | 1240 NEW SCOTLAND RD | ||||||||
| Address2: | |||||||||
| City: | SLINGERLANDS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 121599221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184757075 | ||||||||
| FaxNumber: | 5174757087 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/11/2018 | ||||||||
| LastUpdateDate: | 01/11/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 026670 | NY | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.