Provider Demographics
NPI:1699298620
Name:FABIAN, THOMAS (PHD, CNTP)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:FABIAN
Suffix:
Gender:M
Credentials:PHD, CNTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2960 INCA ST UNIT 206
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-1102
Mailing Address - Country:US
Mailing Address - Phone:303-810-0815
Mailing Address - Fax:
Practice Address - Street 1:2960 INCA ST UNIT 206
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-1102
Practice Address - Country:US
Practice Address - Phone:303-810-0815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist