Individual
MS. ALESA FAZIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
58 HAGERMAN AVE, MEDFORD, NY 11763-2140
(631) 626-4412
Mailing address
58 HAGERMAN AVE, MEDFORD, NY 11763-2140
(631) 626-4412
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
11/12/2009
Last updated
11/12/2009
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