Provider Demographics
NPI:1366658304
Name:FIORE, ANTHONY D (PAC)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:D
Last Name:FIORE
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:350 HENRY ST
Mailing Address - Street 2:3RD. FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-6001
Mailing Address - Country:US
Mailing Address - Phone:718-780-1707
Mailing Address - Fax:718-780-1496
Practice Address - Street 1:339 HICKS ST
Practice Address - Street 2:ANESTHSIA DEPARTMENT
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5509
Practice Address - Country:US
Practice Address - Phone:718-780-1707
Practice Address - Fax:718-780-1496
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY001931-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant