MEDICARE: ROSANGELA FONTANA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	F432369-01	NY

General Provider Information

NPI Number	:	1134807225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSANGELA FONTANA

Provider Business Mailing Address
First Line	:	510 KAPPOCK ST APT 1A
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-6469
Country	:	US
Telephone Number	:	518-390-4833
Fax Number	:

Provider Business Practice Location Address
First Line	:	2159 BROADWAY
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-8207
Country	:	US
Telephone Number	:	917-781-2352
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2023
Last Update Date	:	08/14/2023

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Directions to “ ROSANGELA FONTANA ” Practice Location

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