Mr David J Fortunato, MD | |
75 S Union St, Unit 406, Pawtucket, RI 02860-3978 | |
(401) 741-3154 | |
Not Available |
Full Name | Mr David J Fortunato |
---|---|
Gender | Male |
Speciality | Internal Medicine - Cardiovascular Disease |
Location | 75 S Union St, Pawtucket, Rhode Island |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1205942646 | NPI | - | NPPES |
900525 | Medicaid | RI | |
5256 | Other | BCBS RI | |
DF09421 | Medicaid | RI | |
000812 | Other | BLUE CHIP |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RC0000X | Internal Medicine - Cardiovascular Disease | 5244 (Rhode Island) | Primary |
Entity Name | Prospect Chartercare Sjhsri Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1578988572 PECOS PAC ID: 7315179314 Enrollment ID: O20140721001270 |
Mailing Address | Practice Location Address |
---|---|
Mr David J Fortunato, MD Po Box 8879, Unit 406, Cranston, RI 02920-0879 Ph: (401) 572-3120 | Mr David J Fortunato, MD 75 S Union St, Unit 406, Pawtucket, RI 02860-3978 Ph: (401) 741-3154 |
Mahmoud Mowafy, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 111 Brewster St, Pawtucket, RI 02860 Phone: 401-729-2258 Fax: 401-729-3343 | |
Mriganka Singh, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 407 East Ave, Suite 110, Pawtucket, RI 02860 Phone: 401-728-7270 | |
Amber Gul, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 333 School St, Suite 210, Pawtucket, RI 02860 Phone: 401-726-9790 Fax: 401-728-8606 | |
Dr. Madhavi Yerneni, M.D. Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 407 East Ave, Suite 120, Pawtucket, RI 02860 Phone: 401-725-4700 Fax: 401-725-4740 | |
Waseem Barham, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 111 Brewster St, Pawtucket, RI 02860 Phone: 401-729-2221 Fax: 401-729-2202 | |
Jaleh Fallah, MD Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 111 Brewster St, Pawtucket, RI 02860 Phone: 401-729-2258 Fax: 401-729-3343 | |
Abraham Walusimbi, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 111 Brewster Street, Pawtucket, RI 02860 Phone: 401-729-2258 Fax: 401-729-3343 |