Organization
DE FAZIO OBSTETRICS & GYNECOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK DE FAZIO MD (OWNER)
(718) 836-3721
Entity
Organization
Contact information
Practice address
1301 82ND ST, BOX 26, BROOKLYN, NY 11228-3007
(718) 836-3721
(718) 259-6567
Mailing address
1301 82ND ST, BOX 26, BROOKLYN, NY 11228-3007
(718) 836-3721
(718) 259-6567
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
178425
NY
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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