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NPI Code Detail

MEDICARE: CHRISTINE DOROTHY FASANA

MEDICARE: CHRISTINE DOROTHY FASANA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1225834948
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE DOROTHY FASANA
Provider Business Mailing Address
First Line : 607 GROVE RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29605-4208
Country : US
Telephone Number : 864-766-2001
Fax Number :
Provider Business Practice Location Address
First Line : 607 GROVE RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29605-4208
Country : US
Telephone Number : 864-766-2001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2025
Last Update Date : 02/22/2025

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Directions to “ CHRISTINE DOROTHY FASANA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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