Individual
ASHLEY LYNNE FASSOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1320 STONY BROOK RD STE 100, STONY BROOK, NY 11790-2222
(631) 941-2273
Mailing address
236 HOLBROOK AVE, LAKE RONKONKOMA, NY 11779-1841
(631) 312-2944
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F311865-01
NY
Other
Enumeration date
11/07/2024
Last updated
11/07/2024
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