NINA FIORDALISO (NPI# 1669542593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669542593 |
| Entity Type | Individual |
| Full Name | NINA FIORDALISO |
| Credential | PA |
| Practice Address |
4802 10th Avenue Brooklyn NY 11219 |
| Mailing Address |
Gpo Box 29580 New York NY 10087-9580 |
| Practice Telephone | 7182838773 |
| Practice Fax Number | 7182838796 |
| Mailing Telephone | 7182838773 |
| Mailing Fax Number | 7182838796 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2019-07-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
007483 | NY | Allopathic & Osteopathic Physicians |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
007483 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02622526 | 05 |
| Street Address |
4802 10TH AVENUE |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598746646 | Lawrence Shevlin | Internal Medicine | 4802 10th Avenue, Attn: Mail Room, Brooklyn, NY 11219 | 2005-11-07 |
| 1609371954 | Ogochukwu Okoli | Student in an Organized Health Care Education/Training Program | 4802 10th Avenue, Maimonides Medical Center, Brooklyn, NY 11219 | 2018-03-28 |
| 1124542253 | Shaurya Sharma | Student in an Organized Health Care Education/Training Program | 4802 10th Avenue, Maimonides Medical Center, Brooklyn, NY 11219 | 2017-07-31 |
| 1366963431 | Karis Buford | Student in an Organized Health Care Education/Training Program | 4802 10th Avenue, Maimonides Medical Center, Brooklyn, NY 11219 | 2017-06-29 |
| 1932635000 | Shelly Uppal | Student in an Organized Health Care Education/Training Program | 4802 10th Avenue, Maimonides Medical Center, Brooklyn, NY 11219-1671 | 2017-05-10 |
| 1104352871 | Patria T. Gerardo Arroyo | Student in an Organized Health Care Education/Training Program | 4802 10th Avenue, Maimonides Medical Center, Brooklyn, NY 11219 | 2017-05-02 |
| 1821523846 | Howard Brent | Student in an Organized Health Care Education/Training Program | 4802 10th Avenue, Maimonides Medical Center, Brooklyn, NY 11219 | 2017-04-27 |
| 1982139853 | Josephine E.w. Gathura | Student in an Organized Health Care Education/Training Program | 4802 10th Avenue, Maimonides Medical Center, Brooklyn, NY 11219 | 2017-04-27 |
| 1285169383 | Maria Abramov | Student in an Organized Health Care Education/Training Program | 4802 10th Avenue, Maimonides Medical Center, Brooklyn, NY 11219 | 2017-04-26 |
| 1285169490 | Joseph Aaron Gotesman | Student in an Organized Health Care Education/Training Program | 4802 10th Avenue, Maimonides Medical Center, Brooklyn, NY 11219 | 2017-04-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073127163 | Chava Bokchin | Registered Nurse | 6200 15th Avenue, Brooklyn, NY 11219 | 2020-09-04 |
| 1164033643 | Debbie Evadne Evans-wright | Nurse Practitioner | 979 48th Street, Brooklyn, NY 11219 | 2020-08-10 |
| 1528614559 | Jonathan Benjamin Goldstein | Specialist | Yeled Vyalda 1312 38 Street, Brooklyn, NY 11219 | 2019-08-15 |
| 1235782301 | Vanessa Walton | Social Worker | 4012 New Utrecht Avenue, Apt 1, Brooklyn, NY 11219 | 2019-07-18 |
| 1083184618 | Sandra Murray | Licensed Practical Nurse | 6321 New Utrecht Avenue Second Floor, Brooklyn, NY 11219 | 2018-11-27 |
| 1023588746 | Wanipa Muwowo-nwade | Physician Assistant | 4802 10th Ave Rm 301, Brooklyn, NY 11219 | 2018-11-26 |
| 1366919896 | Evelin Ponce | Licensed Practical Nurse | 6321 New Utrecht Avenue, Second Floor, Brooklyn, NY 11219 | 2018-11-02 |
| 1083180301 | Yefim Simkhayev | Occupational Therapist | 1317 52nd St, Brooklyn, NY 11219 | 2018-10-15 |
| 1598240186 | F & D Pharmacy Inc | Pharmacy | 5504 -13 Ave, Brooklyn, NY 11219 | 2018-09-28 |
| 1245737469 | Yekaterina Joltikov | Student in an Organized Health Care Education/Training Program | Miamonides Medical Center, 4802 10th Ave, Brooklyn, NY 11219 | 2018-04-13 |
| Find all providers in zip 11219 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710517305 | Angenis Lin | Physician Assistant | 1526 83rd St, Brooklyn, NY 11228-3130 | 2020-01-22 |
| 1740848985 | Mallory Des Champs | Physician Assistant | 7901 4th Ave Ste A20, Brooklyn, NY 11209-3957 | 2019-06-03 |
| 1588140230 | Sharon Cheptum Griesinger | Physician Assistant | 276 Hawthorne St Apt 1, Brooklyn, NY 11225-5908 | 2018-07-16 |
| 1336651629 | Francine Panely | Physician Assistant | 460 Neptune Ave Apt 18r, Brooklyn, NY 11224-4325 | 2017-10-26 |
| 1265951479 | Leah Mcmullen | Physician Assistant | 803 Nostrand Ave Apt 1l, Brooklyn, NY 11225-1539 | 2017-09-19 |
| 1033655378 | Zacharia El-samin | Physician Assistant | 21 Pine Tree Ter, Brooklyn, CT 06234-3324 | 2017-01-10 |
| 1982156816 | Chad Smartt | Physician Assistant | 988 E 39th St, Brooklyn, NY 11210-3508 | 2016-10-26 |
| 1154870913 | Christina Masaitis | Physician Assistant | 2171 E 18th St, Apt 1c, Brooklyn, NY 11229-4468 | 2016-09-22 |
| 1447615737 | Eliezer Gurkov | Physician Assistant | 888 Montgomery St, Apt F12, Brooklyn, NY 11213-5888 | 2015-12-31 |
| 1588039846 | Inna Kremen | Physician Assistant | 2829 Ocean Pkwy Ste 3, Brooklyn, NY 11235-7859 | 2015-12-11 |
| Find all providers in BROOKLYN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.