Basic Information
Provider Information | |||||||||
NPI: | 1932295052 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | FLORIO | ||||||||
FirstName: | PHILIP | ||||||||
MiddleName: | LAWRENCE | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 2700 WESTCHESTER AVE FL 2 | ||||||||
Address2: |   | ||||||||
City: | PURCHASE | ||||||||
State: | NY | ||||||||
PostalCode: | 105772547 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9146075730 | ||||||||
FaxNumber: | 9149630517 | ||||||||
Practice Location | |||||||||
Address1: | 1084 N BROADWAY | ||||||||
Address2: |   | ||||||||
City: | YONKERS | ||||||||
State: | NY | ||||||||
PostalCode: | 107011107 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9148488640 | ||||||||
FaxNumber: | 9148488641 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 10/05/2006 | ||||||||
LastUpdateDate: | 03/20/2018 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 134449 | NY | Y |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |   |
ID Information
ID | Type | State | Issuer | Description | 000000037670 | 01 | NY | GHI HMO MEDICAID | OTHER | 0515355 | 01 | NY | AETNA HMO | OTHER | 1000017417 | 01 | NY | AFFINITY | OTHER | 344632 | 01 | NY | EMPIRE BC YONKERS AVE | OTHER | 0201121 | 01 | NY | GHI PPO | OTHER | 10695 | 01 | NY | HUDSON HEALTH PLAN | OTHER | 134449 | 01 | NY | HIP | OTHER | 160043548 | 01 | NY | RAILROAD MEDICARE | OTHER | 4300477 | 01 | NY | AETNA PPO | OTHER | 00539193 | 05 | NY |   | MEDICAID | 1C4684 | 01 | NY | HEALTHNET | OTHER | 344631 | 01 | NY | EMPIRE BC BROADWAY | OTHER | WP522 | 01 | NY | OXFORD | OTHER |