Provider Demographics
NPI:1720311848
Name:FIORI, DANA C (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:C
Last Name:FIORI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:DANA
Other - Middle Name:C
Other - Last Name:CUSHING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:807 S BRAFORD STREET
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-4137
Mailing Address - Country:US
Mailing Address - Phone:302-674-7155
Mailing Address - Fax:302-674-7156
Practice Address - Street 1:807 S BRAFORD STREET
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-4137
Practice Address - Country:US
Practice Address - Phone:302-674-7155
Practice Address - Fax:302-674-7156
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0000673363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE231423YR4Medicare PIN