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General NPI Number Information
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NPI Number | 1982330122
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Entity Type | Individual
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Provider Name | CHRISTINA T FAZIO FNP
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Gender | Female
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Dates
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Enumeration Date | 07/29/2022
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Last Update Date | 05/24/2024
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Provider Practice Location Address
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Address Line | 182 INTREPID LN
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City | SYRACUSE
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State | NY
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Zip | 13205-2545
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Country | US
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Telephone | 315-218-7020
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Fax | 315-218-7050
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Provider Business Mailing Address
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Address Line | 1001 W FAYETTE ST STE 400
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City | SYRACUSE
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State | NY
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Zip | 13204-2866
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Country | US
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Telephone | 315-937-3026
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Fax | 315-937-3126
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F348184-1
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License Number State | NY
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