Individual
MELISSA A FAZZOLARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
270 MAIN ST STE A, PORTLAND, CT 06480-1836
(860) 358-5040
(860) 358-8658
Mailing address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-4870
(860) 358-8661
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
7770
CT
363LG0600X
Gerontology Nurse Practitioner
Primary
7770
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008082360
—
CT
Enumeration date
04/25/2018
Last updated
02/05/2026
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