MRS. SERENA FASANO (NPI# 1215413240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215413240 |
| Entity Type | Individual |
| Full Name | MRS. SERENA FASANO |
| Credential | WHNP, MPH, CLC |
| Practice Address |
13 Bradlee Rd Medford MA 02155-3110 |
| Practice Telephone | 7813951110 |
| Mailing Telephone | 7813951110 |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2018-07-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0000X |
Obstetrics & Gynecology Specialization: Obstetrics |
RN2311932 | MA | Allopathic & Osteopathic Physicians |
| Street Address |
13 BRADLEE RD |
| City | MEDFORD |
| State | MA |
| Zip Code | 02155-3110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538133343 | Ellen Marie Guthrie | Obstetrics & Gynecology | 13 Bradlee Rd, Medford, MA 02155 | 2006-02-16 |
| 1225275944 | Melissa B Outerbridge | Nurse Practitioner | 13 Bradlee Rd, Medford, MA 02155-3110 | 2009-01-16 |
| 1316119951 | Robyn Lee Bianco | Nurse Practitioner | 13 Bradlee Rd, Medford, MA 02155-3110 | 2008-03-24 |
| 1023165941 | Marci Beth Simon | Counselor | 13 Bradlee Rd, Medford, MA 02155-3110 | 2007-01-04 |
| 1255422630 | Mystick Women's Health, Inc. | Obstetrics & Gynecology | 13 Bradlee Rd, Medford, MA 02155-3110 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679113922 | Elena Chapman | Nurse Practitioner | 293 Salem St 4, Medford, MA 02155 | 2020-01-14 |
| 1922658830 | Michelle Anne Zona | Counselor | 100 George Hassett Dr, Medford, MA 02155 | 2019-09-13 |
| 1487138509 | Dava Davainis | Social Worker | 76 Newbern Avenue, Apt. 1, Medford, MA 02155 | 2018-09-25 |
| 1265915128 | Erin Roberts | Counselor | Medford Public Schools, 3002 Mystic Valley Pkwy, Medford, MA 02155 | 2018-09-07 |
| 1871075739 | Janice Madeline Cole | Social Worker | 3820 Mystic Valley Pkwy Unit 805, Medford, MA 02155 | 2018-09-06 |
| 1447732573 | Mystick Women's Health, Inc. | Obstetrics & Gynecology | 13 Bradlee Road, Medford, MA 02155 | 2018-09-05 |
| 1144713090 | Laura Rogers | Psychologist | 203 Paige Hall, 12 Upper Campus Road, Medford, MA 02155 | 2018-06-14 |
| 1871086694 | Shuo Yang | Dentist | 8 9th St Apt 310, Medford, MA 02155 | 2018-06-07 |
| 1891287108 | Xuhua Qin | Psychologist | 120 Curtis Street, Medford, MA 02155 | 2018-06-01 |
| 1568953529 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 471 Salem St, Medford, MA 02155 | 2018-05-25 |
| Find all providers in zip 02155 | ||||
| Taxonomy Code | 207VX0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Obstetrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437601234 | Nicholas Mills Md LLC | Obstetrics & Gynecology | 2941 Doctors Park Dr, Medford, OR 97504-8127 | 2016-10-27 |
| 1942450242 | Hallmark Health Medical Associates Inc | Obstetrics & Gynecology | 170 Governors Ave, Hallmark Health Medical Associates Inc (#2)-non-pchi, Medford, MA 02155-1643 | 2008-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073976932 | Amir Mehdizadeh | Obstetrics & Gynecology | 328 Shrewsbury St Ste 100, Worcester, MA 01604-5465 | 2016-03-29 |
| 1295967669 | Robert Edward Dalessandro | Obstetrics & Gynecology | 23 Theresa Ave, Leominster, MA 01453-4631 | 2009-08-18 |
| 1508925801 | Carl Steven Bender | Obstetrics & Gynecology | One Acton Place, Suite 102, Acton, MA 01720 | 2006-12-06 |
| 1093899346 | New England Ob/gyn Associates,inc | Obstetrics & Gynecology | 200 Boylston St Ste 301, Chestnut Hill, MA 02467-2008 | 2006-10-24 |
| 1942249214 | Peter Brown | Obstetrics & Gynecology | 15 Columbia Rd, Pembroke, MA 02359-1841 | 2006-06-05 |
| 1053392019 | Debra M Papa | Obstetrics & Gynecology | 33 Kendall St, Department of Obstetrics & Gynecology, Worcester, MA 01605-2726 | 2005-11-08 |
| 1619405594 | Dhp of Massachusetts, P.C. | Obstetrics & Gynecology | 70 East St, Methuen, MA 01844-4597 | 2017-05-23 |
| 1730540394 | Uhun Ro Lee M.d P.c | Obstetrics & Gynecology | 45 Pearl St, Brockton, MA 02301-2858 | 2016-03-10 |
| 1356737456 | Jean Chavez Hostage | Obstetrics & Gynecology | 800 Washington St, Boston, MA 02111 | 2015-04-15 |
| 1861810673 | Catherine Dieffenbach | Obstetrics & Gynecology | 165 Dartmouth St, Boston, MA 02116-5123 | 2014-03-31 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.