Individual
MRS. ANGELA M FAZZOLARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP, CCC
Contact information
Practice address
850 MAMARONECK AVE, MAMARONECK, NY 10543-1934
(914) 220-3600
Mailing address
850 MAMARONECK AVE, MAMARONECK, NY 10543-1934
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
017457
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01395326
—
NY
Enumeration date
09/01/2010
Last updated
09/27/2011
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