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

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: August 16, 2026.

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

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. JESSICA FAYE BOUCHARD RPA-C
Physician Assistant (Medical)
4110 MEDICAL CENTER DR
FAYETTEVILLE, NY 13066
Onondaga County (315) 663-0100
AMIN FAZELI MD
Dermatology
4110 MEDICAL CENTER DR, SUITE 110
FAYETTEVILLE, NY 13066
Onondaga County (315) 663-0100
MELISSA ROE PA
Physician Assistant
4110 MEDICAL CENTER DR
FAYETTEVILLE, NY 13066
Onondaga County (315) 663-0100
VADJISTA BROUMAND MD
Internal Medicine
4110 MEDICAL CENTER DR, SUITE 110
FAYETTEVILLE, NY 13066
Onondaga County (315) 663-0100
MS. KATEY WALDON NP
Nurse Practitioner (Family)
4110 MEDICAL CENTER DR
FAYETTEVILLE, NY 13066
Onondaga County (315) 663-0100
RACHEL MARIE DAMON RPA-C
Physician Assistant
4110 MEDICAL CENTER DR
FAYETTEVILLE, NY 13066
Onondaga County (315) 663-0100
CHRISTINE SHAFFER NP
Nurse Practitioner (Family)
4110 MEDICAL CENTER DR
FAYETTEVILLE, NY 13066
Onondaga County (315) 663-0100
MEGHAN L DORAN
Nurse Practitioner (Family)
4110 MEDICAL CENTER DR, SUITE 100
FAYETTEVILLE, NY 13066
Onondaga County (315) 663-0100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

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.

Where is Dr. Fazeli & Dr. Broumand LLC located?

Dr. Fazeli & Dr. Broumand LLC is located at 4110 Medical Center Dr, Fayetteville, NY 13066. The listed phone number is (315) 663-0100.

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

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

When was this NPI record last updated?

The NPPES record for Dr. Fazeli & Dr. Broumand LLC was last updated on March 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.