Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 235759 | NY |
N | 111NI0900X | Internist | 235759 | NY |
Y | 207RX0202X | Medical Oncology | 235759 | NY |
NPI | 1124290044 |
---|---|
Provider Name | Dr. Julie Fasano |
First Address | New York, NY 10029-6504 |
Second Address | New York, NY 10029-6503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2008 |
Last Update Date | 15/03/2019 |