SAMUEL JOSEPH FASULO

BRONX, NY
NPI1710133715
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: NY  017737)
Enumeration Date2008-08-11
Last Update Date2008-08-11
Business Address
Dr. SAMUEL JOSEPH FASULO Ph.D.
111 E 210TH ST
BRONX, NY 10467-2401
Phone number: 718-401-5077
Mailing Address
Dr. SAMUEL JOSEPH FASULO Ph.D.
334 E 148TH ST 2ND FLOOR
BRONX, NY 10451-5707
Phone number: 718-401-5077