Type | Legal entity | [sources] | |||
---|---|---|---|---|---|
Name | FORTUNATO, FRANKLIN | [sources] | |||
Legal form | not available | [sources] | |||
Country | United States of America | [sources] | |||
NPI | 1548278930 | [sources] | |||
Sector | MD | [sources] | |||
Status | not available | [sources] | |||
Address | 127 PINE STREET, MONTCLAIR, NJ 07042 · FMC - DEVENS, PO BOX 879, AYER, MA 01432 | [sources] | |||
Last change | Last processed | First seen |
Medical providers disqualified from participating in New Jersey State's Medicaid program.
United States of America · OIFP
us-mednj-438cb94af52aeb4989ba32063bcf655a43b60590
· us-mednj-e2bdeabf52a5810812d7afa6453afc47e8d6c5f6
For experts: raw data explorer
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Sanctions | |||||
---|---|---|---|---|---|
Country | Authority | Program | Start date | End date | |
United States of America | New Jersey Office of the State Comptroller | - |
Address | ||
---|---|---|
Full address | Country | |
FMC - DEVENS, PO BOX 879, AYER, MA 01432 · FMC DEVENS, PO BOX 879, AYER, MA 01432 | United States of America |
United States of America | New Jersey Office of the State Comptroller | - | - |
127 PINE STREET, MONTCLAIR, NJ 07042 | United States of America |