Provider Demographics
NPI:1194104125
Name:FAZIO, NANCY PATRICIA (FNP)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:PATRICIA
Last Name:FAZIO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:984 N. BROADWAY SUITE #415
Mailing Address - Street 2:GLOBAL MEDICAL SERVICES
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701
Mailing Address - Country:US
Mailing Address - Phone:914-375-3755
Mailing Address - Fax:914-372-9958
Practice Address - Street 1:984 N. BROADWAY SUITE #415
Practice Address - Street 2:GLOBAL MEDICAL SERVICES
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701
Practice Address - Country:US
Practice Address - Phone:914-375-3755
Practice Address - Fax:914-372-9958
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-22
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF339017-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily