Active NPI
Victor Joseph Defazio, PHD
- Psychologist
- Great Neck, NY
National Provider Identifier
1386619211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 004382
- Practice address
- 40 Middle Neck Rd
Great Neck, NY 11021-2307 - Phone
- (516) 829-5227
- Fax
- (516) 829-5227
- NPI assigned
- Feb 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 004382 | NY | Primary |
Addresses
Primary practice location
40 Middle Neck Rd
Great Neck, NY 11021-2307
Mailing address
7 Lincoln Rd
Great Neck, NY 11021-2711
Phone (516) 829-5227
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170125000159 | NY | Practitioner - Clinical Psychologist | 4385801893 | Practice locations: Great Neck, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1386619211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 LINCOLN RD",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110212711",
"telephone_number": "516-829-5227",
"fax_number": "516-829-5227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 MIDDLE NECK RD",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110212307",
"telephone_number": "516-829-5227",
"fax_number": "516-829-5227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEFAZIO",
"first_name": "VICTOR",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-22",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "004382",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.