Jeffrey Fortgang is a Clinical in Newton, Massachusetts. Jeffrey Fortgang practices all healthcare services and medical treatments related to Clinical. The NPI Number for Jeffrey Fortgang is 1912914169. The last update date is 2007-07-08.
Jeffrey Fortgang's current location address is 50 Solon Street, Newton, Massachusetts. You can contact this provider via phone number 6179646822 and fax number 6179646822. The mailing address for Jeffrey Fortgang is 50 Solon Street, Newton, Massachusetts. To know further, please read the information below!
Provider Profile Detail
Provider Name | Jeffrey Fortgang |
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Address | 50 Solon Street, Newton, Massachusetts |
Phone Number | 6179646822 |
Fax Number | 6179646822 |
Sole Proprietor | N |
Credentials | PHD |
NPI Number Detail
NPI Number | 1912914169 |
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Provider Enumeration Date | 2006-08-01 |
Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
Address | 50 Solon Street |
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City | Newton |
State | Massachusetts (MA) |
Post Code | 24611827 |
Phone Number | 6179646822 |
Fax Number | 6179646822 |
Provider's Primary Taxonomy Detail
Speciality | Clinical |
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Taxonomy | 103Tc0700X |
Licence No | 2822 |
Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
W03000 | MA | BLUE CROSS BLUE SHIELD | |
4338079 | AETNA | ||
720563 | TUFTS HEALTH PLAN | ||
14616 | VALUE OPTIONS | ||
526436 | MA | -- | |
151539 | MAGELLAN |
Post Comment/ Review Below
What is the unique identifier code issued to Jeffrey Fortgang by the Centers for Medicare & Medicaid Services (CMS)?
The Jeffrey Fortgang has been assigned the NPI (National Provider Identifier) 1912914169. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Can you provide the Jeffrey Fortgang's physical address?
The Jeffrey Fortgang is physically located at 50 Solon Street, in the city of Newton, MA, with the postal code 24611827.
What is the Jeffrey Fortgang's specialty and taxonomy code?
The Jeffrey Fortgang's specialty is Clinical, and the corresponding taxonomy code is 103Tc0700X.
On what date did Jeffrey Fortgang receive its 1912914169 assignment from the Centers for Medicare & Medicaid Services?
The Jeffrey Fortgang was assigned its 1912914169 on 2006-08-01, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Jeffrey Fortgang most recently updated or revised?
The information pertaining to Jeffrey Fortgang, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.
NPI Number: 1528061710
Address: 19 Nh Route 104, Meredith, NH