Provider Demographics
NPI:1851931539
Name:FIORITO, NICHOLAS M
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:M
Last Name:FIORITO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 DONNY BROOK DR
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07401-1422
Mailing Address - Country:US
Mailing Address - Phone:201-819-8545
Mailing Address - Fax:
Practice Address - Street 1:227 DONNY BROOK DR
Practice Address - Street 2:
Practice Address - City:ALLENDALE
Practice Address - State:NJ
Practice Address - Zip Code:07401-1422
Practice Address - Country:US
Practice Address - Phone:201-819-8545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00262800101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)