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General NPI Number Information
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NPI Number | 1134116155
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Entity Type | Individual
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Provider Name | KAREN FAZIO O.T.
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Gender | Female
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Dates
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Enumeration Date | 10/04/2005
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Last Update Date | 08/09/2011
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Provider Practice Location Address
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Address Line | 4519 SEQUOIA DR APT C230
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City | HARRISBURG
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State | PA
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Zip | 17109-6408
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Country | US
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Telephone | 717-525-8625
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Fax | 717-525-8625
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Provider Business Mailing Address
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Address Line | 4519 SEQUOIA DR APT C230
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City | HARRISBURG
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State | PA
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Zip | 17109-6408
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Country | US
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Telephone | 717-525-8625
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Fax | 717-525-8625
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OC001374L
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License Number State | PA
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