Individual
KRIS ANN FERNICOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
573 VALLEY RD STE 6, WAYNE, NJ 07470-3552
(973) 500-4018
Mailing address
30 BERKLEY CT, WAYNE, NJ 07470-2426
(973) 789-6523
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
08/02/2018
Last updated
05/03/2024
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