Individual
CHRISTINA FASOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 726-2000
Mailing address
15 PARKMAN ST STE 815, BOSTON, MA 02114-3117
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2337289
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2337289
MA
Other
Enumeration date
06/03/2021
Last updated
11/13/2025
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