Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1041C0700X | Clinical Social Worker | 083899-1 | NY |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | F402163-1 | NY |
NPI | 1013212984 |
---|---|
Provider Name | Stephanie Bizzari |
First Address | Auburn, NY 13021-4040 |
Second Address | Auburn, NY 13021-1831 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2011 |
Last Update Date | 21/09/2017 |