Active NPI
Crystal Fasano Boyarsky, FNP
- Nurse Practitioner
- Wallingford, CT
National Provider Identifier
1225850092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 14076
- Practice address
- 850 N Main Street Ext
Wallingford, CT 06492-2400 - Phone
- (203) 804-1888
- NPI assigned
- Oct 31, 2024
- Last updated
- Oct 31, 2024
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 14076 | CT | Primary |
Addresses
Primary practice location
850 N Main Street Ext
Wallingford, CT 06492-2400
Mailing address
850 N Main Street Ext
Wallingford, CT 06492-2400
Phone (203) 804-1888
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14076 | CT | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730332800000",
"number": "1225850092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 N MAIN STREET EXT",
"city": "WALLINGFORD",
"state": "CT",
"postal_code": "064922400",
"telephone_number": "203-804-1888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 N MAIN STREET EXT",
"city": "WALLINGFORD",
"state": "CT",
"postal_code": "064922400",
"telephone_number": "203-804-1888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYARSKY",
"first_name": "CRYSTAL",
"middle_name": "FASANO",
"credential": "FNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-31",
"last_updated": "2024-10-31",
"certification_date": "2024-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CT",
"license": "14076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wallingford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.