Provider Demographics
NPI:1013033778
Name:FORONDA, JEANETTE E (PA)
Entity Type:Individual
Prefix:MS
First Name:JEANETTE
Middle Name:E
Last Name:FORONDA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2106 HARRISBURG PK
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-393-1771
Mailing Address - Fax:717-393-2782
Practice Address - Street 1:2106 HARRISBURG PK
Practice Address - Street 2:SUITE 200
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-393-1771
Practice Address - Fax:717-393-2782
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2022-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA062204363A00000X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant