| | Physician Last Name: | Fasciano |
| | Physician First Name: | Anthony |
| | Physician Middle Name: | Joseph |
| | Address: | 1748 71st Street
Brooklyn, New York 11204 |
| | License Number: | 175805 |
| | License Type: | MD |
| | Year of Birth: |
1960
|
| | Effective Date: | 03/28/2005 |
| | Action Description for DOH Webpage: | Temporary surrender of medical license issued pursuant to New York State Public Health Law Section 230.13.The physician's license status is currently inactive. |
| | Misconduct Description for DOH Webpage: | This order is not disciplinary in nature. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
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