Individual
IDA FAZAKAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
108 MERRIMACK ST, HAVERHILL, MA 01830-5210
(833) 510-4357
Mailing address
4600 MONTGOMERY RD STE 400, CINCINNATI, OH 45212-2600
(513) 873-1269
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2366571
MA
363LA2200X
Adult Health Nurse Practitioner
071464-23
NH
Other
Enumeration date
07/05/2013
Last updated
04/30/2024
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