Organization
FALLON HEALTH WEINBERG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY FASOLINO (EXECUTIVE DIRECTOR)
(716) 810-1828
Entity
Organization
Contact information
Practice address
461 JOHN JAMES AUDUBON PKWY, AMHERST, NY 14228-1141
(716) 810-1895
(716) 250-3160
Mailing address
461 JOHN JAMES AUDUBON PARKWAY, AMHERST, NY 14228
(716) 810-1895
(716) 250-3160
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
03/09/2016
Last updated
03/09/2016
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