National Provider Identifier
Sebastian Salvatore Fasanello, MD
Sebastian Salvatore Fasanello, MD is listed in the NPPES registry with a primary specialty of Emotionally Disturbed Childrens' Residential Treatment Facility in Lackawanna, NY and a listed phone number of (716) 828-9811.
Profile Overview
- NPI
- 1821218819
- Provider Type
- Individual
- Primary Specialty
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Enumeration Date
- May 01, 2007
- Last Updated
- July 08, 2007
Practice Location
- 150 Martin RD
- Lackawanna, NY 14218-2708
Phone: (716) 828-9811
Specialties
- Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X)
Full Record
- NPI
- 1821218819
- Entity Type
- Individual
- Last Name
- Fasanello
- First Name
- Sebastian
- Middle Name
- Salvatore
- Name Prefix
- Dr.
- Credential
- MD
- Mailing Street Address
- 150 Martin RD
- Mailing City
- Lackawanna
- Mailing State
- NY
- Mailing ZIP Code
- 14218-2708
- Mailing Country
- US
- Mailing Phone
- (716) 828-9811
- Mailing Fax
- (716) 828-9363
- Practice Street Address
- 150 Martin RD
- Practice City
- Lackawanna
- Practice State
- NY
- Practice ZIP Code
- 14218-2708
- Practice Country
- US
- Practice Phone
- (716) 828-9811
- Practice Fax
- (716) 828-9363
- Enumeration Date
- May 01, 2007
- Last Updated
- July 08, 2007
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X)