Healthcare Provider Details

I. General information

NPI: 1780870949
Provider Name (Legal Business Name): LUCIA M FABRIZIO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2007
Last Update Date: 05/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 E 70TH ST
NEW YORK NY
10021-4823
US

IV. Provider business mailing address

PO BOX 29234 6G
NEW YORK NY
10087-9234
US

V. Phone/Fax

Practice location:
  • Phone: 212-606-1325
  • Fax: 212-774-7359
Mailing address:
  • Phone: 631-329-6925
  • Fax: 631-329-6951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberF380058
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: