Provider Demographics
NPI:1093856080
Name:NIFOROS, FOTIS (MD)
Entity Type:Individual
Prefix:DR
First Name:FOTIS
Middle Name:
Last Name:NIFOROS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 E POST RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4607
Mailing Address - Country:US
Mailing Address - Phone:914-681-2560
Mailing Address - Fax:914-681-2590
Practice Address - Street 1:41 E POST RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4607
Practice Address - Country:US
Practice Address - Phone:914-681-2560
Practice Address - Fax:914-681-2590
Is Sole Proprietor?:No
Enumeration Date:2007-02-11
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230272207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00230272OtherMETROPLUS
NY1093856080Other1199
NY9583354OtherCIGNA
NYDOC060122-0OtherVNS HEALTH CHOICE
NYNF0272OtherEASY CHOICE (ATLANTIS)
NY112937992NF01OtherLIBERTY HEALTH ADVANTAGE
NY000000109467OtherGHI HMO ID NUMBER
NY0126565OtherGHI PPO ID NUMBER
NY081204000030OtherFIDELIS
NYP4252047OtherUHC-OXFORD LIBERTY PLAN
NY0126565OtherGHI PPO (CBP)
NY11-2937992OtherMAGNACARE
NY112937992OtherEMPIRE PLAN UHC
NY7C2825OtherHEALTHNET
NYPH26708OtherELDER PLAN
NY000000109467OtherGHI HMO
NY112937992OtherMULTIPLAN
NY113CV1 (BW)OtherEMPIRE BLUE CROSS BLUE SHIELD
NY156482POtherHIP PRIS NUMBER
NY230272OtherHIP PROVIDER ID NUMBER
NY2949040OtherUNITED HEALTHCARE
NY000600033241-BWOtherHEALTHPLUS
NY9583354OtherAETNA HEALTHCARE
NYP4252047OtherUNITED HEALTHCARE OXFORD
NY23027260NYOtherAFFINITY
NY541470OtherWELLCARE
NY9583354OtherCIGNA