# RICHARD A. FAZIO MD, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447303128
- **Authorized official:** DR. RICHARD A FAZIO (PRESIDENT)
- **Authorized official phone:** (718) 448-1122

## Contact information

- **Practice address:** 78 TODT HILL RD, SUITE 203, STATEN ISLAND, NY 10314-4528
- **Practice address phone:** (718) 448-1122
- **Practice address fax:** (718) 448-8318
- **Mailing address:** 78 TODT HILL RD, SUITE 203, STATEN ISLAND, NY 10314-4528
- **Mailing address phone:** (718) 448-1122
- **Mailing address fax:** (718) 448-8318

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RG0100X | Gastroenterology Physician | — | NULL | Yes |
| 207RG0100X | Gastroenterology Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/18/2007
- **Last updated:** 04/14/2008