Individual
MR. JOSEPH A FASANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
280 MONTAUK HIGHWAY, BAY SHORE, NY 11706-9182
(631) 758-4444
(631) 758-1984
Mailing address
554 LARKFIELD RD, STE 10A, EAST NORTHPORT, NY 11731-4205
(631) 239-1974
(631) 239-1975
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F304658-1
NY
Other
Enumeration date
10/23/2007
Last updated
01/25/2016
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