Individual
CHRISTOPHER FASO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 W 97TH ST, NEW YORK, NY 10025-6450
(212) 749-1820
Mailing address
62 SCOTT DR, MIDDLETOWN, NY 10941-1118
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
721233-01
NY
Other
Enumeration date
07/29/2020
Last updated
07/29/2020
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