| John J Fazio, CRNA | |
|
1 Heroes Way, Riverhead, NY 11901-2054 | |
| (631) 548-6000 | |
| Not Available |
| Full Name | John J Fazio |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 1 Heroes Way, Riverhead, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356364251 | NPI | - | NPPES |
| 1356364251 | Other | NY | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 375601 (New York) | Primary |
| 163WP0000X | Registered Nurse - Pain Management | 375601 (New York) | Secondary |
| Entity Name | North Shore - Lij Anesthesiology, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417401266 PECOS PAC ID: 1153602453 Enrollment ID: O20161228001498 |
| Mailing Address | Practice Location Address |
|---|---|
| John J Fazio, CRNA 480 Bedford Rd Ste 4202, Chappaqua, NY 10514-1716 Ph: () - | John J Fazio, CRNA 1 Heroes Way, Riverhead, NY 11901-2054 Ph: (631) 548-6000 |
Beth Ann Sawler, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1300 Roanoke Ave, Riverhead, NY 11901 Phone: 631-548-6000 | |
Mrs. Adrienne Clarke, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1300 Roanoke Ave, Riverhead, NY 11901 Phone: 631-766-3437 |