Individual
ELEANOR MARIE FIACCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
35 EMPIRE STATE BLVD, CASTLETON, NY 12033-9777
(518) 477-2167
(518) 477-5182
Mailing address
711 TROY SCHENECTADY RD STE 203, LATHAM, NY 12110-2461
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
347804
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06722687
—
NY
Enumeration date
06/18/2021
Last updated
01/19/2022
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