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General NPI Number Information
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NPI Number | 1063723443
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Entity Type | Individual
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Provider Name | NANCY FASH OTR/L
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Gender | Female
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 06/30/2010
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Provider Practice Location Address
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Address Line | 13401 ROCKAWAY BEACH BLVD
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City | BELLE HARBOR
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State | NY
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Zip | 11694-1450
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Country | US
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Telephone | 718-474-0045
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Fax |
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Provider Business Mailing Address
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Address Line | 431 OCEANSIDE AVE
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City | BREEZY POINT
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State | NY
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Zip | 11697-1923
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Country | US
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Telephone | 718-474-6297
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 005949-1
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License Number State | NY
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