Healthcare Provider Details

I. General information

NPI: 1396382792
Provider Name (Legal Business Name): JESSICA LYNN FINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA LYNN MORCONE

II. Dates (important events)

Enumeration Date: 12/04/2019
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 WASHINGTON ST STE 2A
HARTFORD CT
06106-3322
US

IV. Provider business mailing address

640 BROOKSIDE DR
FAIRFIELD CT
06824-2419
US

V. Phone/Fax

Practice location:
  • Phone: 860-837-9630
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number8642
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number383270
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: