Individual
DR. MARK FORTYGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
601 ELMWOOD AVE., ROCHESTER, NY 14642-0001
(585) 275-1385
(585) 244-7271
Mailing address
601 ELMWOOD AVE BOX 604, ROCHESTER, NY 14642-0001
(585) 275-1385
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
324440
NC
163W00000X
Registered Nurse
734592
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
144048
NY
Other
Enumeration date
07/08/2021
Last updated
06/23/2023
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