Melissa A Fazzolari, APRN | |
850 N Main Street Ext Ste B, Wallingford, CT 06492 | |
(203) 886-0036 | |
(203) 886-0072 |
Full Name | Melissa A Fazzolari |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Gerontology |
Location | 850 N Main Street Ext Ste B, Wallingford, Connecticut |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1477041564 | NPI | - | NPPES |
008082360 | Medicaid | CT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | 7770 (Connecticut) | Secondary |
363LG0600X | Nurse Practitioner - Gerontology | 7770 (Connecticut) | Primary |
Entity Name | Yale University |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093862740 PECOS PAC ID: 9436061736 Enrollment ID: O20031124000690 |
Entity Name | Prohealth Physicians Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720194053 PECOS PAC ID: 1355246950 Enrollment ID: O20031205000602 |
Entity Name | Northeast Medical Group Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1043278351 PECOS PAC ID: 1254233836 Enrollment ID: O20040123000522 |
Entity Name | Practitioner Support Services Llp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1114115706 PECOS PAC ID: 3375596984 Enrollment ID: O20050223000656 |
Entity Name | Connecticut Gi Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023124625 PECOS PAC ID: 9830110758 Enrollment ID: O20070112000011 |
Mailing Address | Practice Location Address |
---|---|
Melissa A Fazzolari, APRN 30 Waterchase Dr, Rocky Hill, CT 06067-2110 Ph: (608) 257-4131 | Melissa A Fazzolari, APRN 850 N Main Street Ext Ste B, Wallingford, CT 06492 Ph: (203) 886-0036 |
Kaitlyn Elizabeth Flynn, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 863 N Main Street Ext Ste 101, Wallingford, CT 06492 Phone: 203-269-3791 | |
Carrie Elizabeth Grassi, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 35 Thorpe Ave Ste 104, Wallingford, CT 06492 Phone: 203-779-5799 | |
Katey Elizabeth Green, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 50 Gaylord Farm Rd, Wallingford, CT 06492 Phone: 203-284-2800 | |
Deborah B Fahs, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 850 N Main Street Ext., Bldg 2 Suite C2, Wallingford, CT 06492 Phone: 203-269-9778 Fax: 203-949-1544 | |
Joan Mary Landino, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 185 Center St, Wallingford, CT 06492 Phone: 203-676-3606 Fax: 203-265-1037 | |
Dr. Erin Elizabeth Sherman, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 74 Cheshire Road, Wallingford, CT 06492 Phone: 203-931-2370 | |
Donna L Mariano, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 67 Masonic Ave, Suite 3100, Wallingford, CT 06492 Phone: 203-284-3144 Fax: 203-284-3150 |