Provider Demographics
NPI:1124009717
Name:KAPLAN-FASTOW, JANA LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:JANA
Middle Name:LYNN
Last Name:KAPLAN-FASTOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2016 JOLLY RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-1014
Mailing Address - Country:US
Mailing Address - Phone:410-653-7807
Mailing Address - Fax:
Practice Address - Street 1:5009 HONEYGO CENTER DR
Practice Address - Street 2:210
Practice Address - City:PERRY HALL
Practice Address - State:MD
Practice Address - Zip Code:21128-9828
Practice Address - Country:US
Practice Address - Phone:443-725-2140
Practice Address - Fax:410-248-0519
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0054793207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology