Healthcare Provider Details

I. General information

NPI: 1144322553
Provider Name (Legal Business Name): JESSICA MARIA TUFINO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 07/02/2021
Certification Date: 07/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 ONTARIO RD NW
WASHINGTON DC
20009-2627
US

IV. Provider business mailing address

2333 ONTARIO RD NW
WASHINGTON DC
20009-2627
US

V. Phone/Fax

Practice location:
  • Phone: 844-796-2797
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberE-6660
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME92914
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA08418000
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD049242
License Number StateDC
# 5
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number60844433
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: