Individual
MISS CHRISTINE FASANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR
Contact information
Practice address
762 DEER PARK RD, DIX HILLS, NY 11746-6221
(631) 549-4900
Mailing address
762 DEER PARK RD, DIX HILLS, NY 11746-6221
(631) 549-4900
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
013412-1
NY
Other
Enumeration date
08/16/2010
Last updated
08/16/2010
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