Individual
JESSICA LYNN FORNIERI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3700 O ST NW, WASHINGTON, DC 20057-0002
(202) 687-6674
Mailing address
964 MANOR LN, BAY SHORE, NY 11706-7506
(631) 456-1330
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
LAT-2710
NC
Other
Enumeration date
04/05/2016
Last updated
03/19/2020
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