Fornasini, Nino Renzo Renzo

Fornasini, Nino Renzo Renzo is an individual health care provider with primary practice located at 3985 Steve Reynolds Blvd Bldg I, Norcross GA 30093-3035. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Fornasini, Nino Renzo Renzo can be contacted via phone (770) 622-3948.

Contact Information

Primary practice address
3985 Steve Reynolds Blvd Bldg I Norcross GA 30093-3035
Phone: (770) 622-3948
Fax: (770) 622-4879
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 48628 Georgia

Profile Details

NPI number 1063586170
LBN Legal business name Fornasini, Nino Renzo Renzo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 20th, 2006
Last updated Jul 19th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063586170 NPPES
Georgia MEDICAID 000879755A

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