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Search › New Jersey › 1041C0700X

Laurel Fastow

NPI 1710740659 · on the registry since 2024

Practice

Address
76 S Orange Ave Ste 214
South Orange, NJ 07079
Phone
(973) 704-4657
Organisation at this address
Jespy House
Jespy House
Jespy House
Jespy House
Kka Ventures Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
8

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Licence states on file
NJ
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2024-04-24

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New Jersey