Organization
PETER FAZIO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER FAZIO DPM (OWNER)
(610) 676-0236
Entity
Organization
Contact information
Practice address
1116A THOMAS RD, WARRINGTON, PA 18976-1842
(215) 343-4573
Mailing address
1116A THOMAS RD, WARRINGTON, PA 18976-1842
(215) 343-4573
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC004353L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0673679000
IBC
PA
01
—
778054
BC/BS
PA
Enumeration date
09/10/2014
Last updated
09/10/2014
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