Individual
MS. MARY ELIZABETH MYLOTT-FASANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
NORTH CENTRAL BRONX HOSPITAL, 3424 KOSSUTH AVE, BRONX, NY 10467
(718) 918-4012
Mailing address
85 SCHRADE RD, BRIARCLIFF MANOR, NY 10510-1410
(914) 610-5225
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F330975
NY
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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