Justin Riece Fazzolari is a New York, New York based Oral and Maxillofacial Surgeon who is specialized in Oral and Maxillofacial Surgery. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Justin Riece Fazzolari is 065003 for Oral and Maxillofacial Surgery in New York. His current practice location is 200 W 57th St Ste 804, New York. Patients can reach him at 646-895-9680.
Justin Riece Fazzolari deals with the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Complete Profile:
Justin Riece Fazzolari speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Name:
Justin Riece Fazzolari
Specialization:
Oral and Maxillofacial Surgeon
Gender:
Male
Credentials:
DMD, MD
Accepts Medicare Assignment:
No
Practice Address:
200 W 57th St Ste 804, New York, New York, 10019-3217
Phone:
646-895-9680
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1295296168
NPI Enumeration Date:
25 Mar, 2019
NPI Last Update On:
19 Aug, 2025
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Justin Riece Fazzolari are as mentioned below.
License Number
Specialization
State
Status
065003
Oral and Maxillofacial Surgery
New York
Primary
22DI03028700
Oral and Maxillofacial Surgery
New Jersey
Secondary
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
200 W 57th St Ste 804, New York, New York
Zip:
10019-3217
Phone Number:
646-895-9680
Patients can reach Justin Riece Fazzolari at 200 W 57th St Ste 804, New York, New York or can call to book an appointment on 646-895-9680. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.