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General NPI Number Information
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NPI Number | 1811186679
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Entity Type | Organization
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Legal Business Name | FRANCIS J FORNO JR DO, LLC
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 03/24/2009
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Provider Practice Location Address
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Address Line | 172 MOUNT PLEASANT RD
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City | NEWTOWN
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State | CT
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Zip | 06470-1443
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Country | US
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Telephone | 203-364-1936
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Fax | 203-364-0839
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Provider Business Mailing Address
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Address Line | 172 MOUNT PLEASANT RD
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City | NEWTOWN
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State | CT
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Zip | 06470-1443
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Country | US
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Telephone | 203-364-1936
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Fax | 203-364-0839
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. KATHRYN AGNES FORNO
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Credential |
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Telephone | 203-364-1936
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 000495
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License Number State | CT
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