Healthcare Provider Details

I. General information

NPI: 1316047699
Provider Name (Legal Business Name): KAREN MARY FARIZO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 ROCKVILLE PIKE
BETHESDA MD
20889-5600
US

IV. Provider business mailing address

7814 EXETER RD
BETHESDA MD
20814-2423
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-4941
  • Fax:
Mailing address:
  • Phone: 301-718-2869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD018204
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: