Individual provider · Type 1 NPI
Melissa A. Fazzolari, APRN
Gerontology Nurse Practitioner · Portland, CT
NPI number
1477041564
Active
Practice location
270 Main St Ste A
Portland, CT 06480-1836
Fax (860) 358-8658
Mailing address
28 Crescent St
Middletown, CT 06457-3654
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | 7770 (CT) |
| Nurse Practitioner | 363L00000X | 7770 (CT) |
Gerontology Nurse Practitioner: Definition to come...
3 other providers at this address
About NPI 1477041564
Melissa A. Fazzolari, APRN's National Provider Identifier is 1477041564, issued on Apr 25, 2018. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Portland, CT. The record was last updated on Feb 5, 2026.