Individual
MRS. AMANDA SUE FORTUNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT RL
Contact information
Practice address
750 E ADAMS ST RM N2104A, PHYSICAL MEDICINE AND REHABILITATION, SYRACUSE, NY 13210-2342
(315) 464-2302
Mailing address
750 E ADAMS ST RM N2104A, PHYSICAL MEDICINE AND REHABILITATION, SYRACUSE, NY 13210-2342
(315) 464-2302
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
014222
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1382J
BC
NC
05
—
7301794
—
NC
Enumeration date
03/30/2006
Last updated
05/27/2008
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