Provider Demographics
NPI:1154481299
Name:FRAZZITTA, MARIE (NP)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:FRAZZITTA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:900 MERCHANTS CONCOURSE STE 216
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-5114
Mailing Address - Country:US
Mailing Address - Phone:516-226-8373
Mailing Address - Fax:844-632-8265
Practice Address - Street 1:1615 NORTHERN BLVD STE GR34
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3008
Practice Address - Country:US
Practice Address - Phone:516-548-8190
Practice Address - Fax:516-365-4980
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF400490363LX0001X
NYF0806216363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology