Individual
MR. THOMAS W FANTAUZZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.PED
Contact information
Practice address
1900 CLINTON AVE S, FEET FIRST INC., ROCHESTER, NY 14618-5621
(585) 442-4990
Mailing address
46 CAPRI DR, THOMAS FANTAUZZO, ROCHESTER, NY 14624-1357
(585) 247-7809
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
NY
Other
Enumeration date
10/08/2010
Last updated
09/10/2014
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