Individual
TARA FAZIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
57 VAN BRUNT AVE, SELDEN, NY 11784-4021
(631) 241-7849
Mailing address
57 VAN BRUNT AVE, SELDEN, NY 11784-4021
(631) 241-7849
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
005294
NY
Other
Enumeration date
08/26/2015
Last updated
08/26/2015
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