=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134235906
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CECILIA FRAZIER CLAIR FNP,RN,MS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/22/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1024 LEXINGTON AVE
-----------------------------------------------------
City | SCHENECTADY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12309-5602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-346-0072
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 CORPORATE WOODS SUITE 350
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14623-1467
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-463-3100
-----------------------------------------------------
Fax | 585-463-3105
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | F334210
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------