Individual provider · Type 1 NPI

Sophia Mary Fornicola, PA-C

Surgical Physician Assistant · Akron, OH

NPI number 1790697688 Active

Practice location

214 W Bowery St
Akron, OH 44308-1046

Call (330) 543-8224 Map

Mailing address

1036 Bennington Ave NE
Massillon, OH 44646-4460

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X50.010635RX (OH)

Surgical Physician Assistant: Definition to come...

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About NPI 1790697688

Sophia Mary Fornicola, PA-C's National Provider Identifier is 1790697688, issued on Sep 17, 2026. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Akron, OH. The record was last updated on Sep 17, 2026.