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GUY MICHAEL FASCIANA M.D.
>> Internal Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1689689341
Individual Registrant: GUY MICHAEL FASCIANA M.D.
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
605 MAIN ST DURYEA, PA 18642-1325 US
Tel: 570-457-1110 Fax: 570-457-2950
Tel: 570-457-1110 Fax: 570-457-2950
Contact information for business:
605 MAIN ST DURYEA, PA 18642-1325 US
Tel: 570-288-5441 Fax: 570-288-5842
Tel: 570-288-5441 Fax: 570-288-5842
Registration Information:
NPI: 1689689341
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207R00000X | Allopathic & Osteopathic Physicians Internal Medicine | PA | MD039471L |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 001004013 | PA | 05 |
