# DE FAZIO OBSTETRICS & GYNECOLOGY, PC

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

## Provider details

- **NPI number:** 1447594916
- **Authorized official:** MARK DE FAZIO MD (OWNER)
- **Authorized official phone:** (718) 836-3721

## Contact information

- **Practice address:** 1301 82ND ST, BOX 26, BROOKLYN, NY 11228-3007
- **Practice address phone:** (718) 836-3721
- **Practice address fax:** (718) 259-6567
- **Mailing address:** 1301 82ND ST, BOX 26, BROOKLYN, NY 11228-3007
- **Mailing address phone:** (718) 836-3721
- **Mailing address fax:** (718) 259-6567

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 178425 | NY | Yes |

## Other

- **Enumeration date:** 11/21/2012
- **Last updated:** 11/21/2012