Individual
JOSEPH FANOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
355 BARD AVE DEPT OF, STATEN ISLAND, NY 10310-1664
(661) 303-5503
Mailing address
355 BARD AVE DEPT OF, STATEN ISLAND, NY 10310-1664
(661) 303-5503
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
205886
CA
Other
Enumeration date
05/01/2023
Last updated
11/18/2025
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