Individual
ANDREW L DEFAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
140 PARK AVE, FLORHAM PARK, NJ 07932-1049
(973) 718-5775
(973) 314-8931
Mailing address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(908) 273-4300
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
231599
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02567242
—
NY
Enumeration date
02/08/2006
Last updated
02/03/2025
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