Individual
ENRICO FAZZINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
108-14 72ND AVENUE, 2ND FLOOR, FOREST HILLS, NY 11375
(718) 263-5600
Mailing address
108-14 72ND AVENUE, 2ND FLOOR, FOREST HILLS, NY 11375
(718) 263-5600
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
157518
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TAX ID
TIN 133530704
NY
Enumeration date
06/27/2006
Last updated
01/25/2008
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