Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 196715 | NY |
Y | 208600000X | Surgeon | 196715 | NY |
N | 208200000X | Surgeon | 25MA06367300 | NJ |
N | 208600000X | Surgeon | 25MA06367300 | NJ |
N | 2082S0105X | Plastic Hand Surgeon | 196715 | NY |
N | 2082S0105X | Plastic Hand Surgeon | 25MA06367300 | NJ |
NPI | 1275520991 |
---|---|
Provider Name | Michael A Fiorillo |
First Address | Pearl River, NY 10965-2253 |
Second Address | Pearl River, NY 10965-2253 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2005 |
Last Update Date | 06/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G54905 | (02) | NY |