Individual
MR. JOSEPH S. FANELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R-PA-C (PHYSICIAN AS
Contact information
Practice address
192 EAST SHORE RD, GREAT NECK, NY 11023
(516) 487-4500
(516) 487-7439
Mailing address
192 EAST SHORE RD, GREAT NECK, NY 11023
(516) 487-4500
(516) 487-7439
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0099421
NY
Other
Enumeration date
08/31/2006
Last updated
11/06/2009
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