Healthcare Provider Details

I. General information

NPI: 1609901263
Provider Name (Legal Business Name): MARGARET FIUMANO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 MONTAUK HWY
WEST ISLIP NY
11795-4411
US

IV. Provider business mailing address

720 MONTAUK HWY
WEST ISLIP NY
11795-4411
US

V. Phone/Fax

Practice location:
  • Phone: 631-669-2900
  • Fax: 631-669-2547
Mailing address:
  • Phone: 631-669-2900
  • Fax: 631-669-2547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number223151
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: