Individual
ANTHONY FASCIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1748 71ST ST APT 1, BROOKLYN, NY 11204-5227
(347) 641-3210
(866) 834-7488
Mailing address
1748 71ST ST APT 1, BROOKLYN, NY 11204-5227
(347) 641-3210
(866) 824-7488
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
175805
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175805
—
NY
Enumeration date
01/17/2016
Last updated
01/17/2016
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