Individual
JESSICA FASSANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-BC
Contact information
Practice address
26901 76TH AVE, NEW HYDE PARK, NY 11040-1433
(718) 470-3956
Mailing address
6822 MADELINE CT, BROOKLYN, NY 11220-5807
(718) 808-5936
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F382804-1
NY
Other
Enumeration date
12/21/2017
Last updated
12/21/2017
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