Individual
ANNA B FAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1419 SHAKESPEARE AVE, BRONX, NY 10452-1851
(718) 732-7080
Mailing address
1419 SHAKESPEARE AVE, BRONX, NY 10452-1851
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141397918
ASTOR
—
Enumeration date
05/22/2015
Last updated
05/22/2015
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