Individual
DOMINIQUE ROSE FORTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
500 WADSWORTH ST, SYRACUSE, NY 13208-3035
(315) 435-4670
Mailing address
302 OAKRIDGE DR, CAMILLUS, NY 13031-2222
(315) 412-3205
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
021867
NY
Other
Enumeration date
01/21/2022
Last updated
01/21/2022
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