Provider Demographics
NPI:1336223668
Name:FIORE, DANIEL E (RPH)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:FIORE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 OAKRIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:CT
Mailing Address - Zip Code:06234
Mailing Address - Country:US
Mailing Address - Phone:860-779-3314
Mailing Address - Fax:
Practice Address - Street 1:42 REYNOLDS STREET
Practice Address - Street 2:
Practice Address - City:DANIELSON
Practice Address - State:CT
Practice Address - Zip Code:06239
Practice Address - Country:US
Practice Address - Phone:860-779-1136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4964183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT8907792000OtherSTATE TAX ID
CT8907792000OtherSTATE TAX ID