Provider Demographics
NPI:1598145914
Name:FABRIZI, RAPHAEL (DPT)
Entity Type:Individual
Prefix:
First Name:RAPHAEL
Middle Name:
Last Name:FABRIZI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 PORTER RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-5716
Mailing Address - Country:US
Mailing Address - Phone:716-298-9390
Mailing Address - Fax:716-298-9391
Practice Address - Street 1:7300 PORTER RD
Practice Address - Street 2:SUITE 3
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-5716
Practice Address - Country:US
Practice Address - Phone:716-298-9390
Practice Address - Fax:716-298-9391
Is Sole Proprietor?:No
Enumeration Date:2015-06-01
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039447225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist