Provider Demographics
NPI:1134368079
Name:GERARD FIORDALISI PT PC
Entity type:Organization
Organization Name:GERARD FIORDALISI PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSCIAL THERAPY
Authorized Official - Prefix:DR
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FIORDALISI
Authorized Official - Suffix:
Authorized Official - Credentials:PT DPT
Authorized Official - Phone:718-389-3131
Mailing Address - Street 1:8 MCGUINNESS BLVD S
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-4997
Mailing Address - Country:US
Mailing Address - Phone:718-389-3131
Mailing Address - Fax:718-389-0625
Practice Address - Street 1:8 MCGUINNESS BLVD S
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-4997
Practice Address - Country:US
Practice Address - Phone:718-389-3131
Practice Address - Fax:718-389-0625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-17
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006109-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty