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Dr. Sebastian Salvatore Fasanello, MD
Emotionally Disturbed Childrens' Residential Treatment Facility in Lackawanna, New York
NPI 1821218819

Sebastian Salvatore Fasanello is a Emotionally Disturbed Childrens' Residential Treatment Facility based in Lackawanna, NY. Sebastian Salvatore Fasanello practices in Lackawanna, NY and has the professional credentials of MD. The NPI Number for Sebastian Salvatore Fasanello is 1821218819 and holds a License No. 090320 (New York).

The current practice location address for Sebastian Salvatore Fasanello is 150 Martin Rd, Lackawanna, NY and can be reached out via phone at 716-828-9811 and via fax at 716-828-9363.

Location: 150 Martin Rd, Lackawanna, NY, 14218-2708
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1821218819
Provider Name
Sebastian Salvatore Fasanello
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
150 Martin Rd, Lackawanna, NY, 14218-2708
Phone Number
716-828-9811
Fax Number
716-828-9363
Provider Enumeration Date
05/01/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
150 Martin Rd
City
Lackawanna
State
New York
Zip
14218-2708
Phone Number
716-828-9811
Fax Number
716-828-9363
person
Provider Business Mailing Address Details
Address
150 Martin Rd
City
Lackawanna
State
New York
Zip
14218-2708
Phone Number
716-828-9811
Fax Number
716-828-9363
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Emotionally Disturbed Children
Speciality
-
Taxonomy
322D00000X
License No.
090320 (New York)
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
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