Provider Demographics
NPI:1598745127
Name:FIORILLI, ANTHONY A SR (OD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:A
Last Name:FIORILLI
Suffix:SR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 CANDLEWOOD COMMONS
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-2172
Mailing Address - Country:US
Mailing Address - Phone:732-367-2040
Mailing Address - Fax:
Practice Address - Street 1:503 CANDLEWOOD COMMONS
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-2172
Practice Address - Country:US
Practice Address - Phone:732-367-2040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00367800152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
222305989OtherTAX ID #
NJ2979004Medicaid
U00831Medicare UPIN
FI521341Medicare ID - Type Unspecified