Healthcare Provider Details

I. General information

NPI: 1053076620
Provider Name (Legal Business Name): PAUL FIUMARA FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 02/09/2023
Certification Date: 02/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1338 MCKEEL ST
YORKTOWN HEIGHTS NY
10598-5005
US

IV. Provider business mailing address

1338 MCKEEL ST
YORKTOWN HEIGHTS NY
10598-5005
US

V. Phone/Fax

Practice location:
  • Phone: 914-656-0121
  • Fax:
Mailing address:
  • Phone: 914-656-0121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF349345-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: