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GUY MICHAEL FASCIANA M.D.

>> Internal Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1689689341

Individual Registrant:
 GUY MICHAEL FASCIANA M.D.
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

Contact information for business:
605 MAIN ST  DURYEA, PA 18642-1325 US
Tel: 570-288-5441  Fax: 570-288-5842

Registration Information:
NPI: 1689689341
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
PAMD039471L

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
001004013PA05




HEALTH CARE JOBS PA - Page 1



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