1. Home
  2. Directory
  3. Massachusetts
  4. Boston
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

OMOTAYO FASAN
NPI 1912852518
Student in an Organized Health Care Education/Training Program in Boston, MA

Active since February 28, 2026
72 E CONCORD ST, BOSTON, MA 02118(617) 358-7477 Get Directions Write a Review

NPPES record last updated: February 28, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Omotayo Fasan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OMOTAYO FASAN (NPI 1912852518) is an individual student in an organized health care education/training program in Boston, Massachusetts and active in the NPI registry since February 2026. She maintains a secondary practice location in Dorchester.

NPPES Registry Identity

NPI1912852518
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameOMOTAYO FASAN
Location Address72 E CONCORD STBoston, MA 02118-2642
Mailing Address72 E Concord StBoston, MA 02118-2642
Phone(617) 358-7477
Sole ProprietorNo
Enumeration DateFebruary 28, 2026
NPPES CertifiedFebruary 28, 2026
✔ NPI 1912852518 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
72 E CONCORD ST, Boston, MA 02118
Open in Google Maps ↗

Secondary Practice Location 1

Location 11353 Dorchester AveDorchester, MA 02122-2932 · Phone (617) 288-3230

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. DENISE M LAUTENBACH M.S.
Genetic Counselor, MS
72 E CONCORD ST, B-7800
BOSTON, MA 02118
Suffolk County (617) 638-5355
DANIELLE LYNN LAFOND
Student in an Organized Health Care Education/Training Program
72 E CONCORD ST, EVANS 124
BOSTON, MA 02118
Suffolk County (617) 414-5951
NICOLE MUSHERO
Internal Medicine (Geriatric Medicine)
72 E CONCORD ST, ROBINSON 2
BOSTON, MA 02118
Suffolk County (617) 638-6100
DR. CHARLES MILROD MD
Internal Medicine
72 E CONCORD ST
BOSTON, MA 02118
Suffolk County (617) 638-6500
SAMANTHA HAYES PEREZ MENENDEZ
Student in an Organized Health Care Education/Training Program
72 E CONCORD ST
BOSTON, MA 02118
Suffolk County (617) 638-8442
TYLER A HARKNESS
Student in an Organized Health Care Education/Training Program
72 E CONCORD ST, EVANS 124
BOSTON, MA 02118
Suffolk County (617) 638-6500
CATHERINE SUTTON
Student in an Organized Health Care Education/Training Program
72 E CONCORD ST
BOSTON, MA 02118
Suffolk County (617) 358-4000
BOSTON MEDICAL CENTER
General Acute Care Hospital
72 E CONCORD ST
BOSTON, MA 02118
Suffolk County (617) 638-9004

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Omotayo Fasan's NPI number?

The NPI number for Omotayo Fasan is 1912852518. It was assigned to this individual provider in the NPPES registry on February 28, 2026.

Where is Omotayo Fasan located?

Omotayo Fasan practices at 72 E Concord St, Boston, MA 02118. The listed phone number is (617) 358-7477.

What is Omotayo Fasan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Omotayo Fasan was last updated on February 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.