Individual
JESSICA LAUREN FOURNIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
711 TROY SCHENECTADY RD STE 114, LATHAM, NY 12110
(518) 786-1600
(518) 786-1606
Mailing address
711 TROY SCHENECTADY RD STE 203, LATHAM, NY 12110-2461
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
269781
MA
2085R0202X
Diagnostic Radiology Physician
Primary
286883
NY
Other
Enumeration date
05/23/2012
Last updated
06/11/2018
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