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| Type | Legal entity | [sources] | |||
|---|---|---|---|---|---|
| Name | FORTUNATO F DANA MD · FORTUNATO, FRANKLIN · Fortunato, Franklin Dana | [sources] | |||
| Legal form | not available | [sources] | |||
| Country | United States | [sources] | |||
| NPI | 1548278930 | [sources] | |||
| Sector | MD · Physician · Physician (MD, DO) - Pulmonary Medicine | [sources] | |||
| Status | not available | [sources] | |||
| Address | 127 PINE STREET, MONTCLAIR, NJ 07042 · FMC - DEVENS, PO BOX 879, AYER, MA 01432 · Montville, NJ 07045 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers disqualified from participating in New Jersey State's Medicaid program.
United States · OIFP
Medical providers deemed ineligible to participate in New York State's Medicaid program.
United States · OMIG
Medical providers excluded from South Carolina's Medicaid program.
United States · SCDHHS
us-medsc-2b16c85e47045b877f2ec6222b85cb6272ed6aaf · us-medny-71579d22c78399356626105fa1ff2e66bff7a191 · us-mednj-438cb94af52aeb4989ba32063bcf655a43b60590 · us-mednj-e2bdeabf52a5810812d7afa6453afc47e8d6c5f6For experts: raw data explorer
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| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States | New Jersey Office of the State Comptroller | - | |||
| Address | ||
|---|---|---|
| Full address | Country | |
| 127 PINE STREET, MONTCLAIR, NJ 07042 | United States | |
| United States | South Carolina Department of Health and Human Services | - | - |
| United States | New York State Office of the Medicaid Inspector General | - | - |
| United States | New Jersey Office of the State Comptroller | - | - |
| FMC - DEVENS, PO BOX 879, AYER, MA 01432 · FMC DEVENS, PO BOX 879, AYER, MA 01432 | United States |