Basic Information
| Provider Information | |||||||||
| NPI: | 1093856080 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NIFOROS | ||||||||
| FirstName: | FOTIS | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 41 E POST RD | ||||||||
| Address2: | |||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106014607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146812560 | ||||||||
| FaxNumber: | 9146812590 | ||||||||
| Practice Location | |||||||||
| Address1: | 41 E POST RD | ||||||||
| Address2: | |||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106014607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146812560 | ||||||||
| FaxNumber: | 9146812590 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/11/2007 | ||||||||
| LastUpdateDate: | 04/27/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 230272 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00230272 | 01 | NY | METROPLUS | OTHER | 1093856080 | 01 | NY | 1199 | OTHER | 9583354 | 01 | NY | CIGNA | OTHER | DOC060122-0 | 01 | NY | VNS HEALTH CHOICE | OTHER | NF0272 | 01 | NY | EASY CHOICE (ATLANTIS) | OTHER | 112937992NF01 | 01 | NY | LIBERTY HEALTH ADVANTAGE | OTHER | 000000109467 | 01 | NY | GHI HMO ID NUMBER | OTHER | 0126565 | 01 | NY | GHI PPO ID NUMBER | OTHER | 081204000030 | 01 | NY | FIDELIS | OTHER | P4252047 | 01 | NY | UHC-OXFORD LIBERTY PLAN | OTHER | 0126565 | 01 | NY | GHI PPO (CBP) | OTHER | 11-2937992 | 01 | NY | MAGNACARE | OTHER | 112937992 | 01 | NY | EMPIRE PLAN UHC | OTHER | 7C2825 | 01 | NY | HEALTHNET | OTHER | PH26708 | 01 | NY | ELDER PLAN | OTHER | 000000109467 | 01 | NY | GHI HMO | OTHER | 112937992 | 01 | NY | MULTIPLAN | OTHER | 113CV1 (BW) | 01 | NY | EMPIRE BLUE CROSS BLUE SHIELD | OTHER | 156482P | 01 | NY | HIP PRIS NUMBER | OTHER | 230272 | 01 | NY | HIP PROVIDER ID NUMBER | OTHER | 2949040 | 01 | NY | UNITED HEALTHCARE | OTHER | 000600033241-BW | 01 | NY | HEALTHPLUS | OTHER | 9583354 | 01 | NY | AETNA HEALTHCARE | OTHER | P4252047 | 01 | NY | UNITED HEALTHCARE OXFORD | OTHER | 23027260NY | 01 | NY | AFFINITY | OTHER | 541470 | 01 | NY | WELLCARE | OTHER |