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1710133715
SAMUEL JOSEPH FASULO
BRONX, NY
NPI
1710133715
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: NY 017737)
Enumeration Date
2008-08-11
Last Update Date
2008-08-11
Business Address
Dr. SAMUEL JOSEPH FASULO Ph.D.
111 E 210TH ST
BRONX, NY 10467-2401
Phone number: 718-401-5077
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Mailing Address
Dr. SAMUEL JOSEPH FASULO Ph.D.
334 E 148TH ST 2ND FLOOR
BRONX, NY 10451-5707
Phone number: 718-401-5077
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