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NPI Code Detail

MEDICARE: GARY FIASCONARO M.D.

MEDICARE: GARY FIASCONARO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician167199NY

General Provider Information

NPI Number : 1740204536
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY FIASCONARO M.D.
Provider Business Mailing Address
First Line : 7502 COLONIAL RD
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-2906
Country : US
Telephone Number : 718-630-5770
Fax Number : 718-680-2011
Provider Business Practice Location Address
First Line : 7502 COLONIAL RD
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-2906
Country : US
Telephone Number : 718-630-5770
Fax Number : 718-680-2011
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 07/08/2007

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