Active NPI
Alyssa Fazzino, MA, CCC-SLP
- Speech-Language Pathologist
- Cromwell, CT
National Provider Identifier
1548759665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5563
- Practice address
- 52 Missionary Rd
Cromwell, CT 06416-2170 - Phone
- (860) 316-4677
- NPI assigned
- May 3, 2018
- Last updated
- May 3, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 5563 | CT | Primary |
Addresses
Primary practice location
52 Missionary Rd
Cromwell, CT 06416-2170
Mailing address
27 Heather CT
Cromwell, CT 06416-1824
Phone (860) 817-3581
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5563 | CT | MD | Mental Health Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525305600000",
"number": "1548759665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 HEATHER CT",
"city": "CROMWELL",
"state": "CT",
"postal_code": "064161824",
"telephone_number": "860-817-3581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "52 MISSIONARY RD",
"city": "CROMWELL",
"state": "CT",
"postal_code": "064162170",
"telephone_number": "860-316-4677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAZZINO",
"first_name": "ALYSSA",
"credential": "MA, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-03",
"last_updated": "2018-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CT",
"license": "5563",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cromwell, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.