Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | X006917-1 | NY |
NPI | 1134319833 |
---|---|
Provider Name | Dr. Patrick Fioriglio |
First Address | Brooklyn, NY 11214-6547 |
Second Address | Brooklyn, NY 11214-6547 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2007 |
Last Update Date | 28/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
X54371 | (02) | NY |