Provider Demographics
NPI:1972886000
Name:FASO, MARY FRANCES (RN)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:FRANCES
Last Name:FASO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 US ROUTE 9
Mailing Address - Street 2:PO BOX 820
Mailing Address - City:VALATIE
Mailing Address - State:NY
Mailing Address - Zip Code:12184
Mailing Address - Country:US
Mailing Address - Phone:518-758-7575
Mailing Address - Fax:518-758-8269
Practice Address - Street 1:2910 US ROUTE 9
Practice Address - Street 2:
Practice Address - City:VALATIE
Practice Address - State:NY
Practice Address - Zip Code:12184
Practice Address - Country:US
Practice Address - Phone:518-758-7575
Practice Address - Fax:518-758-8269
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY354393-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool