Provider Demographics
NPI:1659846632
Name:FUGO, JENNIFER (CNS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:FUGO
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:PA
Mailing Address - Zip Code:19405-1107
Mailing Address - Country:US
Mailing Address - Phone:484-393-2207
Mailing Address - Fax:
Practice Address - Street 1:100 W FORNANCE ST
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3316
Practice Address - Country:US
Practice Address - Phone:484-682-2008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist