Provider Demographics
NPI:1821105966
Name:IORIO, ANTHONY ROBERT (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:ROBERT
Last Name:IORIO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 TITICUS RD
Mailing Address - Street 2:
Mailing Address - City:NORTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10560-2701
Mailing Address - Country:US
Mailing Address - Phone:203-414-4846
Mailing Address - Fax:
Practice Address - Street 1:188 TITICUS RD
Practice Address - Street 2:
Practice Address - City:NORTH SALEM
Practice Address - State:NY
Practice Address - Zip Code:10560-2701
Practice Address - Country:US
Practice Address - Phone:203-414-4846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0006113213E00000X
NYN006119213E00000X
CT000310213EP1101X
NY006119213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2846239Medicaid