Individual
HANNAH L. FASSEL JUSTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-6195
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-8250
(401) 444-6104
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
262725
MA
208000000X
Pediatrics Physician
MD18605
RI
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
MD18605
RI
Other
Enumeration date
07/09/2012
Last updated
08/10/2022
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