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General NPI Number Information
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NPI Number | 1457693848
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Entity Type | Individual
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Provider Name | ANGELA MARIE FAST M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/23/2013
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 8025 BLACK HORSE PIKE STE 300
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City | PLEASANTVILLE
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State | NJ
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Zip | 08232-2962
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Country | US
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Telephone | 609-652-8579
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Fax |
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Provider Business Mailing Address
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Address Line | 8025 BLACK HORSE PIKE STE 300
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City | PLEASANTVILLE
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State | NJ
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Zip | 08232-2962
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Country | US
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Telephone | 609-652-8579
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 21086
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 296644
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD472620
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 25MA12057800
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License Number State | NJ
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