Individual
NICHOLAS FASANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
962 MANOR RD, STATEN ISLAND, NY 10314-7041
(718) 494-2724
Mailing address
572 16TH ST, BROOKLYN, NY 11218-1201
(347) 749-0350
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
—
Other
Enumeration date
02/02/2022
Last updated
02/02/2022
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