Provider Demographics
NPI:1255414439
Name:EDWARD D FIORE MD PA
Entity type:Organization
Organization Name:EDWARD D FIORE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:FIORE MD PA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-349-2067
Mailing Address - Street 1:20 HOSPITAL DR
Mailing Address - Street 2:SUITE 12A
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6434
Mailing Address - Country:US
Mailing Address - Phone:732-349-2067
Mailing Address - Fax:732-341-9164
Practice Address - Street 1:20 HOSPITAL DR
Practice Address - Street 2:SUITE 12A
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6434
Practice Address - Country:US
Practice Address - Phone:732-349-2067
Practice Address - Fax:732-341-9164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ091499Medicare ID - Type Unspecified