Fazzolari, Angela M

Fazzolari, Angela M is an sole proprietor health care provider with primary practice located at 850 Mamaroneck Ave , Mamaroneck NY 10543-1934. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Fazzolari, Angela M can be contacted via phone (914) 220-3600.

Contact Information

Primary practice address
850 Mamaroneck Ave Mamaroneck NY 10543-1934
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 017457 New York

Profile Details

NPI number 1548577356
LBN Legal business name Fazzolari, Angela M
Credentials SLP, CCC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 1st, 2010
Last updated Sep 27th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548577356 NPPES
New York MEDICAID 01395326

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