Individual
DR. ROBERT J FAZIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
613 S 26TH ST, PHILADELPHIA, PA 19146-1010
(215) 514-5113
Mailing address
613 S 26TH ST, PHILADELPHIA, PA 19146-1010
(215) 514-5113
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS016140
PA
Other
Enumeration date
06/16/2009
Last updated
06/16/2009
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