Individual
MRS. SERENA FASANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP, MPH, CLC
Contact information
Practice address
13 BRADLEE RD, MEDFORD, MA 02155-3110
(781) 395-1110
Mailing address
13 BRADLEE RD, MEDFORD, MA 02155-3110
(781) 395-1110
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
RN2311932
MA
Other
Enumeration date
07/12/2018
Last updated
07/12/2018
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