| Richard Anthony Fazio, MD | |
|
78 Todt Hill Rd, Suite 203, Staten Island, NY 10314-4528 | |
| (718) 448-1122 | |
| (718) 448-8318 |
| Full Name | Richard Anthony Fazio |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine - Gastroenterology |
| Location | 78 Todt Hill Rd, Staten Island, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285601419 | NPI | - | NPPES |
| 00767666 | Medicaid | NY | |
| 0023395 | Other | NY | GHI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 140259 (New York) | Primary |
| Entity Name | Richard A. Fazio Md, P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447303128 PECOS PAC ID: 1153210570 Enrollment ID: O20060126000308 |
| Entity Name | Amboy Medical Practice, P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700037975 PECOS PAC ID: 2860538170 Enrollment ID: O20090930000024 |
| Mailing Address | Practice Location Address |
|---|---|
| Richard Anthony Fazio, MD 78 Todt Hill Rd, Suite 203, Staten Island, NY 10314-4528 Ph: (718) 448-1122 | Richard Anthony Fazio, MD 78 Todt Hill Rd, Suite 203, Staten Island, NY 10314-4528 Ph: (718) 448-1122 |
Liliane Sarkis Deeb, M.D. Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 4106 Hylan Blvd, Staten Island, NY 10308 Phone: 718-226-7855 Fax: 718-227-5814 | |
Deepak Vadada, MD Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 1050 Clove Rd, Staten Island, NY 10301 Phone: 718-816-6440 Fax: 718-816-3611 | |
Dr. Samantha Maria Lee, MD Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 475 Seaview Ave, Staten Island, NY 10305 Phone: 718-226-9510 Fax: 718-226-3473 | |
Dr. Jean Chalhoub, M.D Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 475 Seaview Avenue, Department Of Internal Medicine, Staten Island, NY 10305 Phone: 718-226-8855 | |
Roy Subash Kondapavuluru, MD Gastroenterology Medicare: Not Enrolled in Medicare Practice Location: 475 Seaview Ave, Staten Island, NY 10305 Phone: 615-708-2623 | |
Dr. Gustave Stephen Drivas, M.D., Gastroenterology Medicare: Not Enrolled in Medicare Practice Location: 5405 Hylan Blvd, Staten Island, NY 10312 Phone: 718-948-3890 Fax: 718-948-3961 | |
Dr. Beatrice Nogueira, MD Gastroenterology Medicare: Medicare Enrolled Practice Location: 475 Seaview Ave, Staten Island, NY 10305 Phone: 718-226-6902 Fax: 718-226-6844 |