Individual
FASAHAT BANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
2301 BELMONT AVENE, PRIMARY CARE CLINIC IN YOUNGSTOWN, OHIO (VETERANS ADMIN, YOUNGSTOWN, OH 44130
(330) 740-9200
Mailing address
14690 ALI AVE, CLEVELAND, OH 44130-8829
(440) 891-8239
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
57.011241
OH
207R00000X
Internal Medicine Physician
Primary
ME105212
FL
Other
Enumeration date
06/11/2009
Last updated
02/24/2011
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