Individual
NINA FIORDALISO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4802 10TH AVENUE, BROOKLYN, NY 11219
(718) 283-8773
(718) 283-8796
Mailing address
GPO BOX 29580, NEW YORK, NY 10087-9580
(718) 283-8773
(718) 283-8796
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
007483
NY
363AM0700X
Medical Physician Assistant
Primary
007483
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02622526
—
NY
Enumeration date
11/08/2006
Last updated
07/16/2019
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