Healthcare Provider Details

I. General information

NPI: 1144150533
Provider Name (Legal Business Name): JULIA CHRISTINA FORTIN SRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 NEW SCOTLAND AVE
ALBANY NY
12208-3412
US

IV. Provider business mailing address

66 QUEVIC DR
SARATOGA SPRINGS NY
12866-8942
US

V. Phone/Fax

Practice location:
  • Phone: 518-262-5521
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number772851
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: