Individual
GLORIA MCCANN FORTUNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 473-1320
(631) 473-3091
Mailing address
625 BELLE TERRE RD, SUITE 100, PORT JEFFERSON, NY 11777-2316
(631) 473-1320
(631) 473-3091
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
400369
NY
Other
Enumeration date
01/29/2007
Last updated
04/30/2015
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