Healthcare Provider Details

I. General information

NPI: 1982180519
Provider Name (Legal Business Name): LORI FIORENTINO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2018
Last Update Date: 07/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JOHN JAMES AUDUBON PKWY
AMHERST NY
14228-1145
US

IV. Provider business mailing address

197 PARIS RD
NEW HARTFORD NY
13413-5202
US

V. Phone/Fax

Practice location:
  • Phone: 800-342-2898
  • Fax:
Mailing address:
  • Phone: 315-723-5880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF342985
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: