Individual
GREGORY V DEFAZIO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1301 82ND STREET, BROOKLYN, NY 11228
(718) 836-3721
(718) 259-6567
Mailing address
1301 82ND STREET, BOX 26, BROOKLYN, NY 11228
(718) 836-3721
(718) 259-6567
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
198761
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01606046
—
NY
Enumeration date
02/07/2006
Last updated
07/08/2007
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