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1073586343
MARK L DEFAZIO
BROOKLYN, NY
NPI
1073586343
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207V00000X Obstetrics & Gynecology
(Licence: NY 178425)
Enumeration Date
2006-02-08
Last Update Date
2011-09-23
Business Address
-- MARK L DEFAZIO MD
1301 82ND ST
BROOKLYN, NY 11228
Phone number: 718-836-3721
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Mailing Address
-- MARK L DEFAZIO MD
1301 82ND ST BOX 26
BROOKLYN, NY 11228
Phone number: 718-836-3721
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