Dr. Charles Timothy Fasanya, M.D
Surgery, Surgical Critical Care in Middletown, NY. Individual provider (NPI-1).
NPI number1710149356
StatusActive
Last updated in NPPESApr 2, 2018
Details
- NPI
- 1710149356
- Entity type
- Individual (NPI-1)
- Name
- Dr. Charles Timothy Fasanya
- Credential
- M.D
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 25, 2008
- Last updated
- Apr 2, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2086S0102X | Surgery, Surgical Critical Care | 254698 | NY | Yes |
| 208600000X | Surgery | 25MA08347800 | NJ |
Practice location
707 E Main StMiddletown, NY 10940-2650
Phone 845-333-7575 · Fax 845-333-1454
Mailing address
707 E Main StMiddletown, NY 10940-2650
Phone 845-333-1114 · Fax 845-333-2645
Other practice locations
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