Individual
THEODORE PETER FORTUNA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
OPHTHALMIC DISPENSER
Contact information
Practice address
113 MAIN ST, STE 2, BATAVIA, NY 14020
(585) 344-1345
Mailing address
113 MAIN ST, STE 2, BATAVIA, NY 14020
(585) 344-1345
Taxonomy
Speciality
Code
Description
License number
State
156FX1100X
Ophthalmic Technician/Technologist
Primary
5041
NY
Other
Enumeration date
05/10/2006
Last updated
07/08/2007
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