Individual
DR. JOHN R FAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4900 BROAD RD, PATHOLOGY DEPT, SYRACUSE, NY 13215-2265
(315) 492-5096
Mailing address
4567 CROSSROADS PARK DR, 2ND FL, LIVERPOOL, NY 13088-3589
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
191793
NY
Other
Enumeration date
08/24/2005
Last updated
09/12/2007
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