Active NPI
Tara Fazio
- Acupuncturist
- Selden, NY
National Provider Identifier
1104293190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 005294
- Practice address
- 57 Van Brunt Ave
Selden, NY 11784-4021 - Phone
- (631) 241-7849
- NPI assigned
- Aug 26, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 005294 | NY | Primary |
Addresses
Primary practice location
57 Van Brunt Ave
Selden, NY 11784-4021
Mailing address
57 Van Brunt Ave
Selden, NY 11784-4021
Phone (631) 241-7849
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440547200000",
"number": "1104293190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57 VAN BRUNT AVE",
"city": "SELDEN",
"state": "NY",
"postal_code": "117844021",
"telephone_number": "631-241-7849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57 VAN BRUNT AVE",
"city": "SELDEN",
"state": "NY",
"postal_code": "117844021",
"telephone_number": "631-241-7849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAZIO",
"first_name": "TARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-26",
"last_updated": "2015-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "005294",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Selden, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.