SEBASTIAN SALVATORE FASANELLO

LACKAWANNA, NY
NPI1821218819
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy322D00000X Residential Treatment Facility, Emotionally Disturbed Children
(Licence: NY  090320)
Enumeration Date2007-05-01
Last Update Date2007-07-08
Business Address
DR. SEBASTIAN SALVATORE FASANELLO MD
150 MARTIN RD
LACKAWANNA, NY 14218-2708
Phone number: 716-828-9811
Mailing Address
DR. SEBASTIAN SALVATORE FASANELLO MD
150 MARTIN RD
LACKAWANNA, NY 14218-2708
Phone number: 716-828-9811