Fantauzzi, John Patrick

Fantauzzi, John Patrick is an individual health care provider with primary practice located at 711 Troy Schenectady Rd Suite 201, Latham NY 12110-2442. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Fantauzzi, John Patrick can be contacted via phone (518) 782-3700.

Contact Information

Primary practice address
711 Troy Schenectady Rd Suite 201 Latham NY 12110-2442
Phone: (518) 782-3700
Fax: (518) 782-3799
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X D0066858 Maryland
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 233230 New York

Profile Details

NPI number 1649442070
LBN Legal business name Fantauzzi, John Patrick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 26th, 2008
Last updated Jan 18th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649442070 NPPES
New York MEDICAID 03091572

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