Individual
CHRISTINA T FAZIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
182 INTREPID LN, SYRACUSE, NY 13205-2545
(315) 218-7020
(315) 218-7050
Mailing address
1001 W FAYETTE ST STE 400, SYRACUSE, NY 13204-2866
(315) 937-3026
(315) 937-3126
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F348184-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
348184
NYS LICENSE
NY
Enumeration date
07/29/2022
Last updated
05/24/2024
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