Healthcare Provider Details

I. General information

NPI: 1861424533
Provider Name (Legal Business Name): GARY FLORIO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 E GUN HILL RD
BRONX NY
10469-6016
US

IV. Provider business mailing address

124 W 72ND ST SUITE 6C
NEW YORK NY
10023-3356
US

V. Phone/Fax

Practice location:
  • Phone: 646-462-5321
  • Fax:
Mailing address:
  • Phone: 646-462-5321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number189697
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: