Provider Demographics
NPI:1871661280
Name:FIORE, ROSARIO (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ROSARIO
Middle Name:
Last Name:FIORE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ROSARIO
Other - Middle Name:
Other - Last Name:DIAZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1 PENN PLZ STE 8TH
Mailing Address - Street 2:OPTUMCARE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10119-0002
Mailing Address - Country:US
Mailing Address - Phone:347-582-1246
Mailing Address - Fax:855-417-8267
Practice Address - Street 1:1 PENN PLZ FL 8
Practice Address - Street 2:OPTUM
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10119-0899
Practice Address - Country:US
Practice Address - Phone:347-852-1246
Practice Address - Fax:855-417-8267
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333958-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1871661280OtherNPI
NY03883887Medicaid