1275964470 NPI number — ANNETTE FIORILLO, DO P.C.

Table of content: (NPI 1275964470)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275964470 NPI number — ANNETTE FIORILLO, DO P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANNETTE FIORILLO, DO P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LONG ISLAND ALLERGIES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275964470
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/13/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2940 LINCOLN AVE
Provider Second Line Business Mailing Address:
#200
Provider Business Mailing Address City Name:
OCEANSIDE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11572
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-307-9140
Provider Business Mailing Address Fax Number:
516-706-6770

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2940 LINCOLN AVE
Provider Second Line Business Practice Location Address:
#200
Provider Business Practice Location Address City Name:
OCEANSIDE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11572-2195
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-307-9140
Provider Business Practice Location Address Fax Number:
516-706-6770
Provider Enumeration Date:
12/13/2013

Additional Information

Authorized Official

Authorized Official Last Name:
FIORILLO
Authorized Official First Name:
ANNETTE
Authorized Official Middle Name:
LOUISE
Authorized Official Title or Position:
PROVIDER
Authorized Official Telephone Number:
516-307-9140

Provider Taxonomy Codes

  • Taxonomy code: 207K00000X , with the licence number:  243388 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 03162392 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com