Individual
DR. FAUSTO RICARDO CABEZAS BOLANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
450 CLARKSON AVE, BROOKLYN, NY 11203-2012
(718) 270-2848
Mailing address
394 HARMAN ST, BROOKLYN, NY 11237-4683
(857) 800-2961
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
318069-01
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/12/2019
Last updated
04/18/2024
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