Healthcare Provider Details

I. General information

NPI: 1427629682
Provider Name (Legal Business Name): LOUIS E. FIERRO, JR, D.C., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2021
Last Update Date: 07/08/2021
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 MADISON AVE FL 4
NEW YORK NY
10022-1738
US

IV. Provider business mailing address

8 DOGWOOD LN
KATONAH NY
10536-3214
US

V. Phone/Fax

Practice location:
  • Phone: 914-242-4700
  • Fax:
Mailing address:
  • Phone: 914-242-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LOUIS FIERRO JR.
Title or Position: OWNER
Credential: DC
Phone: 941-242-4700