Individual
JENNIFER FASANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15 COMMONWEALTH AVE, WOBURN, MA 01801-5193
(781) 486-0000
(866) 587-4276
Mailing address
15 COMMONWEALTH AVE, WOBURN, MA 01801-5193
(781) 486-0000
(866) 587-4276
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
2801-0104-0356-075
MA
Other
Enumeration date
01/26/2010
Last updated
01/26/2010
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