1902894009 NPI number — GERARD ANDREW FLORIO PHD

Table of content: GERARD ANDREW FLORIO PHD (NPI 1902894009)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902894009 NPI number — GERARD ANDREW FLORIO PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FLORIO
Provider First Name:
GERARD
Provider Middle Name:
ANDREW
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1902894009
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/14/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 PARK ST
Provider Second Line Business Mailing Address:
GLENS FALLS HOSPITAL
Provider Business Mailing Address City Name:
GLENS FALLS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12801-4413
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-926-6620
Provider Business Mailing Address Fax Number:
518-926-1954

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
102 PARK ST
Provider Second Line Business Practice Location Address:
CR WOOD CANCER CENTER
Provider Business Practice Location Address City Name:
GLENS FALLS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12801-4403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-926-6620
Provider Business Practice Location Address Fax Number:
518-926-1954
Provider Enumeration Date:
10/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  013594 , 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: P00092394 . This is a "RR MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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