Individual
DR. RICHARD JOSEPH FASTIGGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
130 CENTER WAY, CORNING, NY 14830-2255
(607) 936-9971
(607) 936-2600
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
171866-1
NY
207RG0100X
Gastroenterology Physician
MD040004E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001097790002
—
PA
05
—
01035905
—
NY
01
—
110209180
RR MEDICARE PIN
PA
01
—
CC8362
RR MEDICARE GROUP
NY
01
—
GU039871
MEDICARE GROUP
PA
Enumeration date
02/24/2006
Last updated
07/29/2011
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