Deborah Fortin, CPNP-BC | |
451 Clarkson Ave, Brooklyn, NY 11203-2097 | |
(718) 245-3131 | |
Not Available |
Full Name | Deborah Fortin |
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Gender | Female |
Speciality | Nurse Practitioner - Pediatrics |
Location | 451 Clarkson Ave, Brooklyn, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1801520150 | NPI | - | NPPES |
00000000 | Other | N/A |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 617528 (New York) | Secondary |
363LP0200X | Nurse Practitioner - Pediatrics | 202121416 (New York) | Primary |
Entity Name | Harmony Health Care Long Island |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1336669670 PECOS PAC ID: 5991970535 Enrollment ID: O20111212000065 |
Entity Name | North Shore - Lij Medical Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053688572 PECOS PAC ID: 3375701568 Enrollment ID: O20120220000262 |
Mailing Address | Practice Location Address |
---|---|
Deborah Fortin, CPNP-BC 67 Haven Ave, Valley Stream, NY 11580-3238 Ph: (646) 361-4502 | Deborah Fortin, CPNP-BC 451 Clarkson Ave, Brooklyn, NY 11203-2097 Ph: (718) 245-3131 |
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