Diane L Fortunato M.D.

NPI 1053313718 - Internal Medicine - 207R00000X

NPI Details
NPI 1053313718
Gender Female
Enumeration Date 08/12/2005
Last Updated 07/27/2009
Entity Type Individual
Active Over 11 years ago
Practice Location
509 ROSEVILLE AVE
NEWARK NJ, 07107-2444, US
Phone (973) 482-0339
Fax
Business Location
PO BOX 7129
NEWARK NJ, 07107-0129, US
Phone (973) 482-0339
Fax
Toxanomy
Taxonomy Code 207R00000X
License State New Jersey
License Number 25MA04648600
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According to our database, Dr. Diane L Fortunato M.D. NPI is 1053313718, taxonomy code is 207R00000X and license number is 25MA04648600, license state is located at New Jersey. Diane L Fortunato M.D. physically located at 509 Roseville Ave, Newark NJ, 07107-2444. NPI Number Diane L Fortunato M.D. has the Individual type.

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1053313718 NPI number is provided on an as is basis without warranty of any kind. 1053313718 is maintained by the National Plan & Provider Enumeration System. The contents of Diane L Fortunato M.D. are for informational purposes only.