Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 25MD09639000 | NJ |
Y | 208600000X | Surgeon | 25MD09639000 | NJ |
N | 208200000X | Surgeon | 287470-1 | NY |
N | 208600000X | Surgeon | 287470-1 | NY |
N | 2086X0206X | Surgical Oncologist | 287470-1 | NY |
NPI | 1427310192 |
---|---|
Provider Name | Marcella Fornari |
First Address | Boston, MA 02241-6457 |
Second Address | Morristown, NJ 07960 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2012 |
Last Update Date | 30/08/2018 |