Fiacco, Eleanor Marie

Fiacco, Eleanor Marie is an individual health care provider with primary practice located at 35 Empire State Blvd , Castleton NY 12033-9777. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Fiacco, Eleanor Marie can be contacted via phone (518) 477-2167.

Contact Information

Primary practice address
35 Empire State Blvd Castleton NY 12033-9777
Phone: (518) 477-2167
Fax: (518) 477-5182
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 347804 New York

Profile Details

NPI number 1679142376
LBN Legal business name Fiacco, Eleanor Marie
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2021
Last updated Jan 19th, 2022 - about 2 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 1679142376 NPPES
New York MEDICAID 06722687

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