Provider Demographics
NPI:1790998896
Name:FIUTAK, KIRA ALVARADO (NP)
Entity Type:Individual
Prefix:
First Name:KIRA
Middle Name:ALVARADO
Last Name:FIUTAK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 GOODSPEED PL
Mailing Address - Street 2:
Mailing Address - City:SKANEATELES
Mailing Address - State:NY
Mailing Address - Zip Code:13152-1309
Mailing Address - Country:US
Mailing Address - Phone:315-685-6738
Mailing Address - Fax:315-685-6738
Practice Address - Street 1:421 MONTGOMERY ST
Practice Address - Street 2:CIVIC CENTER 9TH FLOOR
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-2923
Practice Address - Country:US
Practice Address - Phone:315-435-3295
Practice Address - Fax:315-435-8442
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF420425-1363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health