Individual
THOMAS FACELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
257 LAFAYETTE AVE, SUITE 200, SUFFERN, NY 10901-4830
(845) 369-8800
(845) 357-0086
Mailing address
20 GRAND ST, 3RD FLOOR, WARWICK, NY 10990-1035
(845) 987-3906
(845) 987-5979
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
145054
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002459
GHI
—
01
—
0095911
AETNA HMO
—
05
—
01015883
—
NY
01
—
08647
GHI HMO
—
01
—
089D611
EMPIRE BLUE CROSS
—
01
—
0D3802
HEALTHNET NE
—
01
—
145054
HIP OF NY
—
01
—
4096594
AETNA TRADITIONAL
—
01
—
RS363
OXFORD
—
Enumeration date
09/15/2006
Last updated
11/07/2013
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