MELISSA A FAZZOLARI


Address: 850 N Main Street Ext Ste B, Wallingford, CT 06492
Phone: 2038860036

MELISSA A FAZZOLARI (NPI# 1477041564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1477041564
Entity Type Individual
Full Name MELISSA A FAZZOLARI
Credential APRN
Practice Address 850 N Main Street Ext Ste B
Wallingford
CT 06492
Mailing Address 30 Waterchase Dr
Rocky Hill
CT 06067-2110
Practice Telephone 2038860036
Practice Fax Number 2038860072
Mailing Telephone 6082574131
Mailing Fax Number 8602574519
Enumeration Date 2018-04-25
Last Update Date 2019-08-30
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363L00000X Nurse Practitioner 7770 CT Physician Assistants & Advanced Practice Nursing Providers
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
7770 CT Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
CT 008082360 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
850 N Main Street Ext Ste B, Wallingford, CT 06492 2038860036 2038860072

Office Location

Street Address 850 N MAIN STREET EXT STE B
City WALLINGFORD
State CT
Zip Code 06492

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1891310215 The Promptcare Companies, Inc. Durable Medical Equipment & Medical Supplies 101 Noth Plains Industrial Park, Suite B Building 2 Harvest Park, Wallingford, CT 06492 2020-06-11
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1902370943 Alicia Anne Eldridge Student in an Organized Health Care Education/Training Program 88 Cheshire Road, Wallingford, CT 06492 2019-01-13
1114409562 Doreen Gail Barile Pharmacist 846 North Colony Road, Wallingford, CT 06492 2018-09-02
1942782354 Brad Becker Pharmacist 846 North Colony Rd, Walingford, CT 06492 2018-08-31
1992235857 Karen Ann Meers Behavioral Analyst 29 North Plains Highway, Unit 15, Wallingford, CT 06492 2017-06-14
1992232698 Chelsea Clements Occupational Therapist 87 Southwind Dr, Wallingford, CT 06492 2017-05-12
1659822369 Sara Frawley Naturopath 850 N. Main Street Extention, Building 2 Suite 3c, Wallingford, CT 06492 2016-10-18
1083085518 Energetic Spine Chiropractic Chiropractor 1271 South Broad St., Unit #11, Wallingford, CT 06492 2015-10-09
1730561952 Renee Pamela Borecki Dentist 205 North Main Street, Wallingford, CT 06492 2015-06-24
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Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1316566375 Catherine F Kenney Nurse Practitioner 115 S Providence Rd, Wallingford, PA 19086-6333 2020-04-10
1437308186 Sylvia K Parker Nurse Practitioner 22 Masonic Ave, Wallingford, CT 06492 2008-09-17

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1255956421 Thomas Lorbie Thomson IIi Nurse Practitioner Va Connecticut Healthcare, 950 Campbell Avenue, Mail Code: 11acsl1, Building 2b, West Haven, CT 06516 2020-06-12
1427689660 Sajini M Roy Nurse Practitioner 172 Guinea Rd, Monroe, CT 06468-1044 2020-01-27
1073171393 Sabine Donato Dabady Nurse Practitioner 287 Capitol Ave, Waterbury, CT 06705-2407 2019-06-01
1720599541 Sherifa Bello Nurse Practitioner 1333 Burnside Ave Apt A3, East Hartford, CT 06108-1517 2017-10-19
1750808994 Ronald S. Perpetua Nurse Practitioner 107 Bassett Rd, North Haven, CT 06473-1902 2017-08-28
1891247805 Campbell Medical Care, LLC Nurse Practitioner 22 Parkwood Dr, Windsor, CT 06095-3142 2016-10-26
1861745259 Marguerite Kalowsky Benoit Nurse Practitioner 187 Bouton St W, Stamford, CT 06907-1320 2012-10-22
1396977997 Debra Innes Coyle Nurse Practitioner 85 Huckleberry Ln, Southington, CT 06489-4319 2009-08-14
1487727228 Leeanne E Shaw-quinn Nurse Practitioner 30 Hyde Ave Ste 109, Vernon, CT 06066-4503 2006-11-17
1184648925 Karen S Williams Nurse Practitioner 25 Witch Meadow Rd, Salem, CT 06420-3602 2006-07-26
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Competitor

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City WALLINGFORD
Zip Code 06492

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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