Individual
VICENT M FORTUNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
994 E 180TH ST APT 6C, BRONX, NY 10460-2272
(347) 520-1164
(914) 229-2022
Mailing address
994 E 180TH ST APT 6C, BRONX, NY 10460-2272
(347) 520-1164
(914) 229-2022
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
22-203830
NY
Other
Enumeration date
03/18/2022
Last updated
03/18/2022
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