Provider Demographics
NPI:1134235906
Name:CLAIR, CECILIA FRAZIER (FNP,RN,MS)
Entity type:Individual
Prefix:MS
First Name:CECILIA
Middle Name:FRAZIER
Last Name:CLAIR
Suffix:
Gender:F
Credentials:FNP,RN,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CORPORATE WOODS
Mailing Address - Street 2:SUITE 350
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-1467
Mailing Address - Country:US
Mailing Address - Phone:585-463-3100
Mailing Address - Fax:585-463-3105
Practice Address - Street 1:1024 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12309-5602
Practice Address - Country:US
Practice Address - Phone:518-346-0072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF334210363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4127165OtherMVP HEALTHCARE
NY000407563002OtherBSNENY
NY82336OtherGHI/HMO
NY02501760Medicaid
NY82336OtherGHI/HMO
NYRA4655Medicare ID - Type Unspecified