Provider Demographics
NPI:1194548453
Name:FABRIZIO, CAMRYN GRACE (RN)
Entity type:Individual
Prefix:
First Name:CAMRYN
Middle Name:GRACE
Last Name:FABRIZIO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 BEACH 141ST ST
Mailing Address - Street 2:
Mailing Address - City:BELLE HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1248
Mailing Address - Country:US
Mailing Address - Phone:917-494-5480
Mailing Address - Fax:
Practice Address - Street 1:511 BEACH 141ST ST
Practice Address - Street 2:
Practice Address - City:BELLE HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11694-1248
Practice Address - Country:US
Practice Address - Phone:917-494-5480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY848575163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse