Individual
HILARY FAZZONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
202 STEVENS AVE, MIGNONE MEDICAL EYE CARE PC, MT. VERNON, NY 10550
(914) 664-6001
(914) 668-0110
Mailing address
400 COLUMBUS AVE, CREDENTIALING SPECIALIST, NEW HAVEN, CT 06519-1233
(203) 503-3174
(203) 503-3183
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
215120
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02427769
—
NY
Enumeration date
11/03/2005
Last updated
09/06/2018
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