Individual
ALESSIO FASANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT STREET, YAWKEY 6B-6800, BOSTON, MA 02114
(617) 724-8476
(617) 643-2384
Mailing address
175 CAMBRIDGE STREET CPZS-574, PEDIATRIC GASTROENTEROLOGY, BOSTON, MA 02114
(617) 726-1450
(617) 724-2710
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
D46661
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203721100
—
MD
Enumeration date
06/10/2006
Last updated
02/27/2013
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