Healthcare Provider Details

I. General information

NPI: 1346209012
Provider Name (Legal Business Name): SHARON LEE FALASCO PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

448 WHITE SPRUCE BLVD
ROCHESTER NY
14623-1608
US

IV. Provider business mailing address

448 WHITE SPRUCE BLVD
ROCHESTER NY
14623-1608
US

V. Phone/Fax

Practice location:
  • Phone: 585-424-6240
  • Fax: 585-424-5395
Mailing address:
  • Phone: 585-424-6240
  • Fax: 585-424-5395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number009848-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: