Individual
DR. JILLIAN LEA FORTIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
263 FARMINGTON AVE, RESIDENCY ADMINISTRATION- AG093, FARMINGTON, CT 06030-1921
(860) 679-2147
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-8080
(860) 679-1430
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
060797
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/20/2010
Last updated
11/07/2022
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