Healthcare Provider Details

I. General information

NPI: 1538684931
Provider Name (Legal Business Name): MICHAEL SCOTT FIORINI PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2017
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

478 KENT AVE APT 506B
BROOKLYN NY
11249-3569
US

IV. Provider business mailing address

478 KENT AVE APT 506B
BROOKLYN NY
11249-3569
US

V. Phone/Fax

Practice location:
  • Phone: 646-543-2707
  • Fax:
Mailing address:
  • Phone: 646-543-2707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number026551
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: