NPI 1801595152

Fazeila Ovalle, PBT

Practitioner Technician Nanuet, NY

Practice location

Address: 111 Avalon Gardens Dr, Nanuet, NY 10954-7415
Phone: (845) 390-0769

Registered specialties

Technician Primary

Nursing Service Related Providers Taxonomy 374700000X Licence Q7F2D7H4 (NY)

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Registry record

NPI: 1801595152
Entity type: Individual
Sex (as registered): Female
NPI issued: 27 Feb 2023
Record last updated: 27 Feb 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.