| Doctor Name: | MICHAEL PAUL FANUCCHI |
| NPI Number: | 1043327620 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 139415 |
| Business Practice Address: | 19 Bradhurst Avenue Suite 2750s Hawthorne, NY - 105236007 |
| Business Phone Number: | 9149099018 |
| Business Fax Number: | 9144932416 |
| Mailing Address: | 19 Bradhurst Avenue, Suite 2300 HAWTHORNE |
| State: | NY |
| Postal Code: | 105236007 |
| Phone Number: | 9144932220 |
| Fax Number: | |
| NPI Enumeration Date: | 08/23/2006 |
| NPI Last Update Date: | 12/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RX0202X |
| License Number: | 139415 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Medical Oncology |
| Taxonomy Definition: | An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer. |