Individual
ELAYNA MARIE FAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 E MOUNTAIN DR, WILKES BARRE, PA 18711-0001
(570) 808-7300
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA062752
PA
363AM0700X
Medical Physician Assistant
MA062752
PA
Other
Enumeration date
11/18/2021
Last updated
02/14/2022
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