MEDICARE: JOSEPH A FIORILLE R.PH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	029854	NY

General Provider Information

NPI Number	:	1366656019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH A FIORILLE R.PH

Provider Business Mailing Address
First Line	:	4892 STATE ROUTE 52
Second Line	:	PO BOX 617
City	:	JEFFERSONVILLE
State	:	NY
Zip	:	12748-0617
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4892 STATE ROUTE 52
Second Line	:
City	:	JEFFERSONVILLE
State	:	NY
Zip	:	12748-0617
Country	:	US
Telephone Number	:	845-482-5720
Fax Number	:	845-482-5771

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	07/08/2007

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