Healthcare Provider Details

I. General information

NPI: 1518128396
Provider Name (Legal Business Name): CHRISTINE JANE FORGIONE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 06/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW PASQUERILLA HEALTH CENTER, SECOND FLOOR
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

3225 GRACE ST NW APT 214
WASHINGTON DC
20007-3641
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-8601
  • Fax:
Mailing address:
  • Phone: 908-581-1394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD039819
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101251162
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0073342
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: