Individual
MARY JO FAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
69 DELAWARE AVE, BUFFALO, NY 14202-3812
(716) 852-5900
Mailing address
78 PRESIDIO PL, BUFFALO, NY 14221-3726
(716) 228-8402
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
459944-01
NY
Other
Enumeration date
06/28/2021
Last updated
06/28/2021
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