Individual
ANTHONY LEONARD FORTUNATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
3300 MAIN ST, 3RD FL SUITE C&D, SPRINGFIELD, MA 01107-1112
(413) 794-5600
(413) 794-7297
Mailing address
280 CHESTNUT ST, 2ND FLOOR, SPRINGFIELD, MA 01199-1001
(413) 794-5700
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
155076
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110084126A
—
MA
Enumeration date
08/12/2009
Last updated
04/10/2017
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