Individual
JANINE FIORELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NPP
Contact information
Practice address
405 LOCUST AVE, OAKDALE, NY 11769-1651
(631) 567-1626
(631) 567-1648
Mailing address
4 JEFFERSON RD, FARMINGDALE, NY 11735-2206
(516) 586-4742
(516) 586-4742
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F400871-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112XJ04091
MEDICARE PROVIDER #
—
01
—
F400871-1
LICENSE
NY
Enumeration date
11/16/2006
Last updated
12/09/2015
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