Roman Fazylov, PHARM.D.

Primary specialty

Pharmacotherapy PharmacistTaxonomy code 1835P1200X

License

059235 Issued in NY

Practice address

800 2ND Ave
New York, NY 10017-4709

Phone

(646) 918-7363

NPI assigned

Nov 28, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1448668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448668800000",
    "number": "1609240845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15333 77TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673127",
            "telephone_number": "646-519-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 2ND AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100174709",
            "telephone_number": "646-918-7363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZYLOV",
        "first_name": "ROMAN",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-28",
        "last_updated": "2015-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "NY",
            "license": "059235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim M Fazio, LPN
• Taylor Marie Fazio
• Jessamine Fazli-Ahmed, MD
• Fazlollah Fraydoon Moqtaderi PC
• Jonathan Fazylov
• Roberta Fazylova
• Violetta Fazylova
• David A Fazzari, PH.D.
• Dominick M Fazzari, D.C.
• Christina Fazzolare

• Pharmacotherapy Pharmacist in New York, NY
• Providers in New York, NY by specialty
• Pharmacotherapy Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2015; 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.