Andrew John Fabozzi, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

031644 Issued in NY

Practice address

75 New Scotland Ave
Albany, NY 12208-3409

Phone

(518) 447-9611

Fax

(518) 426-2902

NPI assigned

Apr 12, 2010

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 12, 2010.

{
    "created_epoch": "1271030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271030400000",
    "number": "1992021398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 NEW SCOTLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083409",
            "telephone_number": "518-447-9611",
            "fax_number": "518-426-2902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 NEW SCOTLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083409",
            "telephone_number": "518-447-9611",
            "fax_number": "518-426-2902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABOZZI",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-12",
        "last_updated": "2010-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "031644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Executive Woods Ambulatory Surgery Center LLC
• Executive Woods Sleep Disorder Ctr LLC
• Ez Psychiatry, PLLC
• Elizabeth Ef Fabian
• Kathryn Ann Fabian, CRNA
• Jenna Fabozzi, NP
• Lynn D Fabre, NP
• Ramon A. Fabregas, M.D.
• Oluwaseun Fadairo
• Giovanni Faddoul, M.D.

• All providers in Albany, NY
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2010; 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.