DR. FAZELI & DR. BROUMAND LLC
NPI 1336235639
Dermatology in Fayetteville, NY

Q: What is Dr. Fazeli & Dr. Broumand LLC's NPI number?

The NPI number for Dr. Fazeli & Dr. Broumand LLC is 1336235639. It was assigned to this organization in the NPPES registry on October 5, 2006.

Q: What is Dr. Fazeli & Dr. Broumand LLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Active since October 05, 2006

4110 MEDICAL CENTER DR, FAYETTEVILLE, NY 13066(315) 663-0100(315) 663-0052 Get Directions Write a Review

NPPES record last updated: March 7, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Fazeli & Dr. Broumand Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. FAZELI & DR. BROUMAND LLC (NPI 1336235639) is a healthcare organization registered as a dermatology in Fayetteville, New York and active in the NPI registry since October 2006. The organization lists Amin Fazeli, President, as its authorized official.

NPPES Registry Identity

NPI1336235639

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NameDR. FAZELI & DR. BROUMAND LLC

Location Address4110 MEDICAL CENTER DRFayetteville, NY 13066-6613

Mailing Address4110 Medical Center DrFayetteville, NY 13066-6613 · (315) 663-0100 · Fax (585) 663-0052

Phone(315) 663-0100

Fax(315) 663-0052

Organization SubpartNo

Authorized OfficialAmin FazeliPresident · (315) 663-0100

Enumeration DateOctober 5, 2006

Last NPPES UpdateMarch 7, 2024

NPPES CertifiedMarch 7, 2024

✔ NPI 1336235639 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

4110 MEDICAL CENTER DR, Fayetteville, NY 13066

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Fazeli & Dr. Broumand Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 15 clinicians reassign Medicare billing to Dr. Fazeli & Dr. Broumand LLC, which bills Medicare for the services they deliver. Of these, 8 practice at this address and 11 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 4

Nurse Practitioner11

Dermatology2

General Surgery1

Internal Medicine1

Clinicians, nearest first (15)

Danielle Bedford, FNP-C

Nurse Practitioner

NPI 1588409791

4110 MEDICAL CENTER DR STE 110
Fayetteville, NY 13066

(315) 992-6308