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1992166342
MATTHEW FASANO
STATEN ISLAND, NY
NPI
1992166342
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 315121)
Enumeration Date
2016-03-13
Last Update Date
2016-03-13
Business Address
-- MATTHEW FASANO
47 JEROME AVE
STATEN ISLAND, NY 10305-3601
Phone number: 917-450-3191
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Mailing Address
-- MATTHEW FASANO
47 JEROME AVE
STATEN ISLAND, NY 10305-3601
Phone number: 917-450-3191
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