Provider Demographics
NPI:1962798504
Name:FORNARI, TAMMY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:
Last Name:FORNARI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HAWES WAY
Mailing Address - Street 2:T-2258
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-1162
Mailing Address - Country:US
Mailing Address - Phone:781-847-4003
Mailing Address - Fax:781-847-4013
Practice Address - Street 1:1 HAWES WAY
Practice Address - Street 2:T-2258
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-1162
Practice Address - Country:US
Practice Address - Phone:781-847-4003
Practice Address - Fax:781-847-4013
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH232768183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist