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General NPI Number Information
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NPI Number | 1346712353
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Entity Type | Individual
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Provider Name | FODAY JANNEH
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Gender | Male
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Dates
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Enumeration Date | 01/02/2019
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 600 N 2ND ST STE 401
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City | HARRISBURG
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State | PA
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Zip | 17101-1071
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Country | US
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Telephone | 860-788-6404
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Fax | 877-794-3529
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Provider Business Mailing Address
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Address Line | PO BOX 2762
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City | WORCESTER
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State | MA
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Zip | 01613-2762
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Country | US
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Telephone | 860-788-6404
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Fax | 877-794-3529
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP028389
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP019800
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License Number State | PA
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