Individual
STACEY FORNAROTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2649 SCHOENERSVILLE RD, STE 201, BETHLEHEM, PA 18017-7326
(610) 868-6880
(610) 868-5333
Mailing address
PO BOX 1754, ALLENTOWN, PA 18105-1754
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA002023L
PA
363AM0700X
Medical Physician Assistant
MP20000
NJ
Other
Enumeration date
02/15/2006
Last updated
09/09/2013
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