Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Omotayo Fasan

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1912852518

Omotayo Fasan is a Student in an Organized Health Care Education/Training Program in Boston, Massachusetts. Works from 2 locations. Registered with an NPI since 2026.

In the registry since
2026

Practice location Address checks out

72 E Concord St
Boston, MA 02118-2642
Phone: (617) 358-7477
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1353 Dorchester Ave, Dorchester, MA 02122-2932 — (617) 288-3230

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1912852518
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 28, 2026
Last updated in NPPESFebruary 28, 2026
Certification dateFebruary 28, 2026

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