Provider Demographics
NPI:1548306087
Name:MICHAEL A.FIORILLO, MD, PC.
Entity type:Organization
Organization Name:MICHAEL A.FIORILLO, MD, PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:FIORILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-623-6141
Mailing Address - Street 1:150 S PEARL ST
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-2236
Mailing Address - Country:US
Mailing Address - Phone:845-623-6141
Mailing Address - Fax:
Practice Address - Street 1:150 S PEARL ST
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-2236
Practice Address - Country:US
Practice Address - Phone:845-623-6141
Practice Address - Fax:845-623-1998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196715208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWXRRZ1Medicare PIN
NYG54905Medicare UPIN
NJ958394Medicare PIN