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FANTAUZZI MARK

Debarred entity

FANTAUZZI MARK is a person of interest. They have not been found on international sanctions lists.

Type	Person				[sources]
Name	FANTAUZZI MARK · Mark Fantauzzi				[sources]
Birth date	not available				[sources]
Nationality	not available				[sources]
Country	United States of America				[sources]
First name	Mark				[sources]
ID Number	`00182556` · `OS007986L`				[sources]
Last name	Fantauzzi				[sources]
NPI	`1831179084`				[sources]
Sector	Physician				[sources]
Title	DO				[sources]
Address	MO, MO				[sources]
Last change	2024-11-29	Last processed	2025-10-02	First seen	2024-09-02

Sanctions
Country	Authority	Program	Start date	End date
United States of America	Department of Human Services		2013-04-18	-

Address
Full address	Country
(MO), (MO) · -MO, -MO · MO, MO	United States of America

Medical providers deemed ineligible to participate in New York State's Medicaid program.

United States of America · OMIG

Medical providers who are precluded from participation in the Medical Assistance Program

United States of America · DHS

Source data IDs: us-medpa-bc084b0a4b3b681fb57a07052172aad0cf77a209 · us-medny-6f5d0778ce4d0b52f481e9a7f37edb8f82079011

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