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1821218819
SEBASTIAN SALVATORE FASANELLO
LACKAWANNA, NY
NPI
1821218819
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
322D00000X Residential Treatment Facility, Emotionally Disturbed Children
(Licence: NY 090320)
Enumeration Date
2007-05-01
Last Update Date
2007-07-08
Business Address
Dr. SEBASTIAN SALVATORE FASANELLO md
150 MARTIN RD
LACKAWANNA, NY 14218-2708
Phone number: 716-828-9811
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Mailing Address
Dr. SEBASTIAN SALVATORE FASANELLO md
150 MARTIN RD
LACKAWANNA, NY 14218-2708
Phone number: 716-828-9811
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