Provider Demographics
NPI:1164516159
Name:FIORE, NICOLE M (PT)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:M
Last Name:FIORE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 OLD FARM RD S
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-1505
Mailing Address - Country:US
Mailing Address - Phone:914-224-9679
Mailing Address - Fax:
Practice Address - Street 1:81 OLD FARM RD S
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570-1505
Practice Address - Country:US
Practice Address - Phone:914-224-9679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025866225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ52961Medicare ID - Type UnspecifiedPHYSICAL THERAPIST