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General NPI Number Information
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NPI Number | 1447657192
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Entity Type | Individual
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Provider Name | DORI FORTUNATO DAOM, LIC. AC. LMT
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Gender | Female
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Dates
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Enumeration Date | 11/24/2014
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 2228 MONTAUK HWY
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City | BRIDGEHAMPTON
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State | NY
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Zip | 11932-4001
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Country | US
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Telephone | 631-500-5452
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1142
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City | SHELTER ISLAND HEIGHTS
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State | NY
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Zip | 11965-1142
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Country | US
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Telephone | 631-374-2728
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 27027339
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25005472
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License Number State | NY
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