Individual
VENKA D FASULO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N
Contact information
Practice address
1355 84 STREET, UPK CENTER, BROOKLYN, NY 11209
(718) 621-8510
(718) 621-8515
Mailing address
1355 84 STREET, UPK CENTER, BROOKLYN, NY 11209
(718) 621-8510
(718) 621-8515
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
662382-1
NY
Other
Enumeration date
12/13/2016
Last updated
12/13/2016
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