Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr Fazeli & Dr Broumand LLC

Organization Dermatology Physician · NPI 1336235639

Dr Fazeli & Dr Broumand LLC is a Dermatology Physician in Fayetteville, New York. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

4110 Medical Center Dr
Fayetteville, NY 13066-6613
Phone: (315) 663-0100
Fax: (315) 663-0052
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X

Record details

NPI number1336235639
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Amin Fazeli — President · (315) 663-0100
NPI enumeratedOctober 5, 2006
Last updated in NPPESMarch 7, 2024
Certification dateMarch 7, 2024
Mailing address4110 Medical Center Dr, Fayetteville, NY 13066-6613

Other providers in Fayetteville