Individual
AMELIA FASCIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
510 JACKSON AVE, NORTHFIELD, NJ 08225-1631
(609) 383-0200
(609) 383-8352
Mailing address
510 JACKSON AVE, NORTHFIELD, NJ 08225-1631
(609) 383-0200
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00853400
NJ
Other
Enumeration date
10/05/2018
Last updated
10/05/2018
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