Louis Fazen, MD, PHD

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

License

65020 Issued in CT

Practice address

135 College St FL 3
New Haven, CT 06510-2483

Phone

(203) 785-4197

NPI assigned

Jun 12, 2015

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1457732703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 COLLEGE ST FL 3",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065102483",
            "telephone_number": "203-785-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 COLLEGE ST FL 3",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065102483",
            "telephone_number": "203-785-4197"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 Chapel St Fl 2",
            "address_2": "YNHH PCC, St Raphael Campus",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065114405",
            "country_code": "US",
            "telephone_number": "203-789-4044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAZEN",
        "first_name": "LOUIS",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-12",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CT",
            "license": "65020",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Said Faulwell
• Edward Vincent Faustino, MD
• Rima L Fawaz, MD
• Amanda Kathryn Faxon, PA-C
• Liam J Fay, PA-C
• Muhammad H Fazili
• David Fealey, MD
• Kathleen Anne Fearn, MD
• Katherine Jane Feder, MD
• Carolyn M Federici, APRN

• Preventive Medicine/Occupational Environmental Medicine Physician in New Haven, CT
• Providers in New Haven, CT by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.