Individual
DR. JUSTIN FERNICOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 2ND AVE, LONG BRANCH, NJ 07740-6303
(732) 222-5200
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
99369
GA
207X00000X
Orthopaedic Surgery Physician
MD.48591
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/30/2018
Last updated
05/21/2024
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