Individual
AMANDA FAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, RN
Contact information
Practice address
31 GREENRIDGE AVE, APARTMENT 1B, WHITE PLAINS, NY 10605-1213
(201) 463-4720
Mailing address
31 GREENRIDGE AVE, APARTMENT 1B, WHITE PLAINS, NY 10605-1213
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
092732
CT
163W00000X
Registered Nurse
654833-1
NY
363LF0000X
Family Nurse Practitioner
F339602
NY
Other
Enumeration date
07/09/2014
Last updated
07/22/2015
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