Joseph J Fazalare in Bridgeport - Sports Medicine
Joseph J Fazalare - NPI 1336307941
Joseph J Fazalare is a Sports Medicine in Bridgeport, . Joseph J Fazalare practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for Joseph J Fazalare is 1336307941. The last update date is 2023-03-07.
Joseph J Fazalare's current location address is 527 Medical Park Dr Ste 400, Bridgeport, . You can contact this provider via phone number 6813423500 and fax number 6813423507. The mailing address for Joseph J Fazalare is 527 Medical Park Dr Ste 400, Bridgeport, . To know further, please read the information below!
Provider Profile Detail
| Provider Name | Joseph J Fazalare |
|---|---|
| Address | 527 Medical Park Dr Ste 400, Bridgeport, |
| Phone Number | 6813423500 |
| Fax Number | 6813423507 |
| Sole Proprietor | Y |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1336307941 |
|---|---|
| Provider Enumeration Date | 2008-05-30 |
| Last Updated Date | 2023-03-07 |
Provider Mailing Address Detail
| Address | 527 Medical Park Dr Ste 400 |
|---|---|
| City | Bridgeport |
| State | (WV) |
| Post Code | 263309010 |
| Phone Number | 6813423500 |
| Fax Number | 6813423507 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Medicine |
|---|---|
| Taxonomy | 207Xx0005X |
| Licence No | 24001 |
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Definition: An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, train |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4293261 | WV | MEDICARE PTAN | |
| 3810018178 | WV | MEDICAID |
Post Comment/ Review Below
What is the unique identifier code issued to Joseph J Fazalare by the Centers for Medicare & Medicaid Services?
The Joseph J Fazalare has been assigned the NPI (National Provider Identifier) 1336307941. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Joseph J Fazalare is geographically located?
The Joseph J Fazalare is physically situated at the following location: 527 Medical Park Dr Ste 400, Bridgeport, WV, 263309010.
What is Joseph J Fazalare's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Joseph J Fazalare is Sports Medicine, and the taxonomy code that classifies this field of practice is 207Xx0005X.
On what date did the Centers for Medicare & Medicaid Services issue the 1336307941 to Joseph J Fazalare?
The Joseph J Fazalare received its 1336307941 assignment from the Centers for Medicare & Medicaid Services on 2008-05-30.
As of what date was the information pertaining to Joseph J Fazalare, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Joseph J Fazalare, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2023-03-07.