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Contact Information

CHARLES T FASANYA, MD
707 E MAIN ST
MIDDLETOWN, NY10940-2650
 Phone: 845-333-7575
 Fax: 845-333-1454
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical Critical Care

2086S0102X 02 Physician/General Surgery
 

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for CHARLES T FASANYA · (Male)

NPI # 1710149356
Status Active
Credentials MD
Entity Individual
Enumeration date 06/25/2008
Last updated 04/02/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • NJ License # 25MA08347800
  • NY License # 254698
  • NJ Medicaid 0181781
  • NJ Other 25MA08347800 MEDICAL LICENSE
  • NY Other 254698 NEW YORK STATE LICENSE
Hospital affiliation(s)
  • EL CENTRO REGIONAL MEDICAL CENTER - (Acute Care)
    1415 ROSS AVENUE
    EL CENTRO, CA 92243
  • GOOD SAMARITAN HOSPITAL MEDICAL CENTER - (Acute Care)
    1000 MONTAUK HIGHWAY
    WEST ISLIP, NY 11795
  • ST JOSEPH HOSPITAL - (Acute Care)
    4295 HEMPSTEAD TURNPIKE
    BETHPAGE, NY 11714
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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