Healthcare Provider Details

I. General information

NPI: 1518372036
Provider Name (Legal Business Name): VICTORIA FASICK D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2014
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1044 BELMONT AVE
YOUNGSTOWN OH
44504-1006
US

IV. Provider business mailing address

800 GARFIELD AVE
PARKERSBURG WV
26101-5340
US

V. Phone/Fax

Practice location:
  • Phone: 330-480-7320
  • Fax: 330-729-1591
Mailing address:
  • Phone: 304-424-2111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036170036
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number3157
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0116027393
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: