Provider Demographics
NPI:1710121249
Name:FIORE, KELLY (MD)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:FIORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75-59 263RD STREET THE ZUCKER-HILLSIDE HOSPITAL,
Mailing Address - Street 2:ADULT OUTPATIENT PSYCHIATRY, SLOMAN-LOWENSTEIN BUILDING
Mailing Address - City:GLEN OAKS
Mailing Address - State:NY
Mailing Address - Zip Code:11004
Mailing Address - Country:US
Mailing Address - Phone:718-470-8080
Mailing Address - Fax:
Practice Address - Street 1:75-59 263RD STREET THE ZUCKER-HILLSIDE HOSPITAL,
Practice Address - Street 2:ADULT OUTPATIENT PSYCHIATRY, SLOMAN-LOWENSTEIN BUILDING
Practice Address - City:GLEN OAKS
Practice Address - State:NY
Practice Address - Zip Code:11004
Practice Address - Country:US
Practice Address - Phone:718-470-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253309-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry