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Individual

MICHAEL THOMAS FASTIGGI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
16 POCONO RD STE 100, DENVILLE, NJ 07834-2905
(973) 784-6868
Mailing address
16 POCONO RD STE 100, DENVILLE, NJ 07834-2905
(973) 784-6868

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25MA11027800
NJ
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/15/2015
Last updated
12/18/2025
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