Individual
JOHN J FIORDALISI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2800 MARCUS AVE, NEW HYDE PARK, NY 11042-1008
(516) 622-6131
(516) 622-7401
Mailing address
35 HAMPTON BAYS DR, HAMPTON BAYS, NY 11946-3007
(631) 723-0622
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
1692381
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
299T01
BC/BS
NY
01
—
45F35ZT2E1
MEDICARE PIN/TPAN
—
Enumeration date
10/25/2006
Last updated
08/24/2009
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