Individual
FRANCES LIBORIA FASULLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9007 156TH AVE, HOWARD BEACH, NY 11414-2719
(646) 250-5839
Mailing address
9007 156TH AVE, HOWARD BEACH, NY 11414-2719
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
103T50200X
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103T50200X
PSYCHOLOGIST
NY
Enumeration date
03/31/2011
Last updated
03/31/2011
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