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Individual

MRS. TIANA FAZIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
285 SILLS RD STE A, EAST PATCHOGUE, NY 11772-4869
(631) 475-0332
Mailing address
25 NESCONSET AVE, NESCONSET, NY 11767-1915
(631) 338-8980

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F383310-01
NY

Other

Enumeration date
03/14/2023
Last updated
03/14/2023
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