Individual
ALYSSA LYNN FORTUNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
113 MAIN ST, BATAVIA, NY 14020-2100
(585) 344-1345
Mailing address
210 ENCHANTED FRST N, DEPEW, NY 14043-5010
(716) 912-5240
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
009183
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/30/2020
Last updated
01/20/2021
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