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Individual
DR. SAMANTHA JO FASO
Active
Individual
DR. SAMANTHA JO FASO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
065821
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
065821
NYS PHARMACIST LICENSE
NY
Enumeration date
09/13/2019
Last updated
09/13/2019
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