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General NPI Number Information
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NPI Number | 1043430242
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Entity Type | Organization
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Legal Business Name | DIEGO M FIORENTINO DO FACP LLC
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Dates
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Enumeration Date | 04/27/2007
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Last Update Date | 06/10/2008
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Provider Practice Location Address
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Address Line | 200 SOUTH NEW ROAD
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City | ABSECON
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State | NJ
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Zip | 08201
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Country | US
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Telephone | 609-641-2062
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Fax | 609-641-4633
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Provider Business Mailing Address
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Address Line | PO BOX 876
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City | ABSECON
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State | NJ
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Zip | 08201
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Country | US
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Telephone | 609-641-2062
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Fax | 609-641-4633
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. DIEGO MICHAEL FIORENTINO
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Credential | DO FACP
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Telephone | 609-641-2062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MB069439
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MB050409
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License Number State | NJ
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