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NPI Code Detail

MEDICARE: PETER FORNETTI

MEDICARE: PETER FORNETTI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1720832397
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER FORNETTI
Provider Business Mailing Address
First Line : 2124 SOUTH ST # 3
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19146-1227
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 W GERMANTOWN PIKE
Second Line :
City : PLYMOUTH MEETING
State : PA
Zip : 19462-1417
Country : US
Telephone Number : 267-755-9464
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2024
Last Update Date : 04/11/2024

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Directions to “ PETER FORNETTI ” Practice Location

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