DR. MATTHEW E FASANO (NPI# 1720634587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720634587 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW E FASANO |
| Other Name | DR. MATTHEW ERIC FASANO-MCCARRON |
| Credential | PSYD |
| Practice Address |
9 Hope Ave Waltham MA 02453-2741 |
| Mailing Address |
300 Longwood Ave Boston MA 02115-5724 |
| Practice Telephone | 7812162100 |
| Mailing Telephone | 6173556000 |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2019-11-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
11129 | MA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 300 Longwood Ave, Boston, MA 021155724 | 2674006989 | |
| 300 Longwood Ave, Boston, MA 021155724 | 6173556000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992166342 | Matthew Fasano | Licensed Practical Nurse | 47 Jerome Ave, Staten Island, NY 10305-3601 | 2016-03-13 |
| Street Address |
9 HOPE AVE |
| City | WALTHAM |
| State | MA |
| Zip Code | 02453-2741 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821083767 | Robert Kevin Mcintyre | Internal Medicine | 9 Hope Ave, Suite 152, Waltham, MA 02453 | 2005-09-16 |
| 1295341972 | Maria Elizabeth Galassi | Speech-Language Pathologist | 9 Hope Ave, Waltham, MA 02453-2741 | 2020-09-18 |
| 1376162446 | Jillian Mangone | Speech-Language Pathologist | 9 Hope Ave, Waltham, MA 02453-2741 | 2020-04-09 |
| 1538798806 | Karen Veilleux | Physical Therapist | 9 Hope Ave, Waltham, MA 02453-2741 | 2020-04-07 |
| 1255998597 | Andrew Mancini | Speech-Language Pathologist | 9 Hope Ave, Waltham, MA 02453-2741 | 2019-05-22 |
| 1679056170 | Chelsea Mello | Occupational Therapist | 9 Hope Ave, Waltham, MA 02453-2741 | 2018-09-11 |
| 1619459229 | Jessica Mcguire | Social Worker | 9 Hope Ave, Waltham, MA 02453-2741 | 2018-08-30 |
| 1174019590 | Jocelyn Hulburt | Nurse Practitioner | 9 Hope Ave, Waltham, MA 02453-2741 | 2018-07-09 |
| 1023502481 | Mary Woodland | Social Worker | 9 Hope Ave, Waltham, MA 02453-2741 | 2018-06-19 |
| 1366932147 | Lisa Stebar | Social Worker | 9 Hope Ave, Waltham, MA 02453-2741 | 2018-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811595770 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 66 Seyon St, Waltham, MA 02453 | 2020-10-13 |
| 1679040935 | Elsa L. Lichman | Social Worker | 52 Derby Street, Waltham, MA 02453 | 2018-10-25 |
| 1760957468 | Sherry Leigh Miller | Counselor | C/o Children's Charter, 77 Rumford Ave, Waltham, MA 02453 | 2018-10-09 |
| 1639644651 | Leo V Sarkissian | Social Worker | The Arc of Massachusetts, 217 South Street, Waltham, MA 02453 | 2018-10-05 |
| 1629569512 | Abaytum Investments Inc | Home Health | 24 Crescent Street, Suite 104, Waltham, MA 02453 | 2018-05-25 |
| 1225542970 | Mikayla E Culpo | Nurse Practitioner | 9 Hope Ave Fl Bch4, Waltham, MA 02453 | 2017-11-16 |
| 1568975449 | Twyla Atherna Everett | Massage Therapist | 212 Calvary St, Waltham, MA 02453 | 2017-11-14 |
| 1407369382 | Eli Miller | Counselor | 431 River Street, Suite 1, Waltham, MA 02453 | 2017-11-14 |
| 1396263927 | Jill Zaricor | Student in an Organized Health Care Education/Training Program | 77 Rumford Ave C/o Children's Charter, Waltham, MA 02453 | 2017-09-04 |
| 1538683008 | Michael Scaduto | Physical Therapist | 110-1 Clematis Ave, Waltham, MA 02453 | 2017-07-27 |
| Find all providers in zip 02453 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558850479 | Laurie Horowitz Humbert | Psychologist | 60 Clements Rd, Waltham, MA 02453-8208 | 2018-05-07 |
| 1467978569 | Rachel Margaret Kantor | Psychologist | 860 Winter St, Waltham, MA 02451-1449 | 2017-08-21 |
| 1750779005 | Katherine L E Craigen | Psychologist | 69 Hickory Dr Ste 2000, Waltham, MA 02451-1011 | 2015-01-08 |
| 1972903250 | Emily Brooke Hotz | Psychologist | 40 Crescent St Ste 201, Waltham, MA 02453-4313 | 2014-08-24 |
| 1770992059 | Hope Elisabeth Forbes | Psychologist | 175 Forest St., Bentley University Counseling Center, Waltham, MA 02452 | 2014-08-12 |
| 1992015275 | Julia Fomicheva | Psychologist | 411 Waverley Oaks Rd., #104, Waltham, MA 02452-8449 | 2010-10-20 |
| 1477792679 | Ronald Howard Evans | Psychologist | 415 South St., Brandeis University, Psychological Counseling, Mailman, Waltham, MA 02454-9110 | 2009-02-11 |
| 1871768762 | Vicky Lyn Anderson | Psychologist | 45 South Street Mailmun House, Brandeis University Psychological Counseling Center, Waltham, MA 02453 | 2008-04-23 |
| 1902023591 | Jane L. Forsyth | Psychologist | 30 Curve Street, Waltham, MA 02451 | 2007-04-18 |
| 1982752168 | Aurelie Jones Goodwin | Psychologist | 159 Virginia Rd, Waltham, MA 02453-7615 | 2007-01-06 |
| Find all providers in WALTHAM | ||||
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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.