Healthcare Provider Details

I. General information

NPI: 1386901882
Provider Name (Legal Business Name): KEVIN PETER FIORI JR. MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2012
Last Update Date: 04/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 E 161ST ST
BRONX NY
10451-3535
US

IV. Provider business mailing address

3544 JEROME AVE
BRONX NY
10467-1005
US

V. Phone/Fax

Practice location:
  • Phone: 718-579-2500
  • Fax:
Mailing address:
  • Phone: 718-920-5521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number279147
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: