Provider Demographics
NPI:1740460146
Name:FIORE, LINDA (RPH)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:FIORE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 AVENUE U
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-3817
Mailing Address - Country:US
Mailing Address - Phone:718-946-4370
Mailing Address - Fax:718-373-9149
Practice Address - Street 1:237 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-3817
Practice Address - Country:US
Practice Address - Phone:718-946-4370
Practice Address - Fax:718-373-9149
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037468183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01016531Medicaid