Healthcare Provider Details

I. General information

NPI: 1942854401
Provider Name (Legal Business Name): LARA B BELFIORE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2019
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 HOBART ST
UTICA NY
13501-4308
US

IV. Provider business mailing address

111 HOSPITAL DR
UTICA NY
13502-2517
US

V. Phone/Fax

Practice location:
  • Phone: 315-798-1149
  • Fax: 315-801-3565
Mailing address:
  • Phone: 315-624-6099
  • Fax: 315-624-6744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number344564
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: