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DUSTIN JOHN FANCIULLO M.D. NPI 1013164052


NPI Information

NPI: 1013164052
Provider Name: DUSTIN JOHN FANCIULLO, M.D.
Classification: Surgery - 2086S0129X
Entity Type: Individual

Specialization: Vascular Surgery

PECOS Registration: Yes

Address:
1445 PORTLAND AVE
SUITE 108
ROCHESTER, NY
ZIP 14621
Phone: (585) 922-5550
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Dustin John Fanciullo, M.D. is a vascular surgery surgery in Rochester, NY with 20 years of experience. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. Dustin John Fanciullo, M.D. NPI is 1013164052. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1445 PORTLAND AVE
SUITE 108
ROCHESTER, NY
ZIP 14621-036
Phone: (585) 922-5550
Fax: (585) 922-0450

The NPI 1013164052 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/21/2008 and was last updated on 5/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12086S0129XSurgeryVascular Surgery252553-1NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.