IndividualActive
Sebastian Fasanello, MD
NPI 1821218819 · Emotionally Disturbed Childrens' Residential Treatment Facility · Lackawanna, NY
Provider details
- NPI number
- 1821218819
- Entity type
- Individual
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 090320 (NY)
Specialties & taxonomies
Residential Treatment Facilities
Practice location
150 Martin Rd
Lackawanna, NY 14218-2708
Phone: (716) 828-9811
Fax: (716) 828-9363
Approximate (ZIP-level) locationGet directions
Mailing address
150 Martin Rd
Lackawanna, NY 14218-2708
Registry dates
- Enumerated
- 2007-05-01
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.