| Doctor Name: | MS. SAMANTHA FAST |
| NPI Number: | 1043537525 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS,RD,LDN |
| License Number: | 006904 |
| Business Practice Address: | 40 Park Ave New York, NY - 100163467 |
| Business Phone Number: | 7817189244 |
| Business Fax Number: | |
| Mailing Address: | 10 Centennial Drive, PEABODY |
| State: | MA |
| Postal Code: | 01960 |
| Phone Number: | 9785351110 |
| Fax Number: | 9785352907 |
| NPI Enumeration Date: | 04/23/2010 |
| NPI Last Update Date: | 01/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 006904 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |