Healthcare Provider Details

I. General information

NPI: 1437285715
Provider Name (Legal Business Name): MICHAEL JOHN FIORE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 DOUGLAS RD
FAR HILLS NJ
07931-2512
US

IV. Provider business mailing address

110 DOUGLAS RD
FAR HILLS NJ
07931-2512
US

V. Phone/Fax

Practice location:
  • Phone: 973-713-2670
  • Fax: 908-234-2416
Mailing address:
  • Phone: 973-713-2670
  • Fax: 908-234-2416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number25MA02665700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: