Healthcare Provider Details

I. General information

NPI: 1972886844
Provider Name (Legal Business Name): TIMOTHY DIIORIO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2011
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 5TH AVE FL 3
NEW YORK NY
10016-8728
US

IV. Provider business mailing address

245 5TH AVE FL 3
NEW YORK NY
10016-8728
US

V. Phone/Fax

Practice location:
  • Phone: 347-980-1480
  • Fax:
Mailing address:
  • Phone: 347-980-1480
  • Fax: 917-814-2450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number334905
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: