Provider Demographics
NPI:1033384631
Name:PARADISI, FIORELLA
Entity Type:Individual
Prefix:
First Name:FIORELLA
Middle Name:
Last Name:PARADISI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 DAVIS RD
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-3302
Mailing Address - Country:US
Mailing Address - Phone:212-545-2438
Mailing Address - Fax:646-312-0481
Practice Address - Street 1:17 DAVIS RD
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-3302
Practice Address - Country:US
Practice Address - Phone:201-727-3241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY581048-1163W00000X
NY401807363LP0808X
NJ26NJ00634600363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
NY00695941Medicaid
NY331947Medicare Oscar/Certification
NY331043Medicare Oscar/Certification
NY331058Medicare Oscar/Certification
NY331943Medicare Oscar/Certification
NY331952Medicare Oscar/Certification
NY331945Medicare Oscar/Certification
NY331944Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification
NY331946Medicare Oscar/Certification
NY331009Medicare Oscar/Certification
NY331954Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification