Individual
LOUIS FAZEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
135 COLLEGE ST FL 3, NEW HAVEN, CT 06510-2483
(203) 785-4197
Mailing address
135 COLLEGE ST FL 3, NEW HAVEN, CT 06510-2483
(203) 785-4197
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
65020
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/12/2015
Last updated
10/02/2020
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