Provider Demographics
NPI:1164629978
Name:FIERRO, LOUIS JR (DC)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:
Last Name:FIERRO
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 RADIO CIRCLE DR STE 2
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-2625
Mailing Address - Country:US
Mailing Address - Phone:914-242-4700
Mailing Address - Fax:914-242-9233
Practice Address - Street 1:40 RADIO CIRCLE DR STE 2
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2625
Practice Address - Country:US
Practice Address - Phone:914-242-4700
Practice Address - Fax:914-242-9233
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008832111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX4A131Medicare ID - Type Unspecified