Active NPI
Vicent M Fortuna
- Behavior Technician
- Bronx, NY
National Provider Identifier
1295484236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 22-203830
- Practice address
- 994 E 180TH St Apt 6C
Bronx, NY 10460-2272 - Phone
- (347) 520-1164
- Fax
- (914) 229-2022
- NPI assigned
- Mar 18, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 22-203830 | NY | Primary |
Addresses
Primary practice location
994 E 180TH St Apt 6C
Bronx, NY 10460-2272
Mailing address
994 E 180TH St Apt 6C
Bronx, NY 10460-2272
Phone (347) 520-1164
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22-203830 | NY | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647561600000",
"number": "1295484236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "994 E 180TH ST APT 6C",
"city": "BRONX",
"state": "NY",
"postal_code": "104602272",
"telephone_number": "347-520-1164",
"fax_number": "914-229-2022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "994 E 180TH ST APT 6C",
"city": "BRONX",
"state": "NY",
"postal_code": "104602272",
"telephone_number": "347-520-1164",
"fax_number": "914-229-2022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTUNA",
"first_name": "VICENT",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-03-18",
"last_updated": "2022-03-18",
"certification_date": "2022-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NY",
"license": "22-203830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.