Healthcare Provider Details

I. General information

NPI: 1467430470
Provider Name (Legal Business Name): MICHAEL A. FABRIZIO M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

387 COLUMBUS AVENUE EXT
PITTSFIELD MA
01201-4909
US

IV. Provider business mailing address

387 COLUMBUS AVENUE EXT
PITTSFIELD MA
01201-4909
US

V. Phone/Fax

Practice location:
  • Phone: 413-443-9629
  • Fax: 413-445-6523
Mailing address:
  • Phone: 413-443-9629
  • Fax: 413-445-6523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number43684
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number43684
License Number StateMA

VIII. Authorized Official

Name: KATHLEEN L FABRIZIO
Title or Position: MEDICAL PRACTICE ADMINISTRATOR
Credential: MBA
Phone: 413-698-3335