Provider Demographics
NPI:1790994382
Name:ROSANO FIORE, FILOMENA AGNES (OD)
Entity Type:Individual
Prefix:DR
First Name:FILOMENA
Middle Name:AGNES
Last Name:ROSANO FIORE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20635 RICHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-3228
Mailing Address - Country:US
Mailing Address - Phone:718-464-8398
Mailing Address - Fax:
Practice Address - Street 1:7933 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-1210
Practice Address - Country:US
Practice Address - Phone:516-921-3937
Practice Address - Fax:516-921-3938
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT005075152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU55229Medicare UPIN