Healthcare Provider Details

I. General information

NPI: 1083295364
Provider Name (Legal Business Name): CHRISTOPHER DIFIORE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2021
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 COUNTY RD 97, STONY BROOK NY 11794
STONY BROOK NY
11794-0001
US

IV. Provider business mailing address

11 ENGLISH IVY LN
LAKE GROVE NY
11755-1846
US

V. Phone/Fax

Practice location:
  • Phone: 631-689-8333
  • Fax:
Mailing address:
  • Phone: 516-983-7291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: