Basic Information
Provider Information
NPI: 1104885201
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FOX
FirstName: NORRIS
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 16 GUION PL
Address2: ISELIN HALL, ROOM 107
City: NEW ROCHELLE
State: NY
PostalCode: 108015503
CountryCode: US
TelephoneNumber: 9146371357
FaxNumber: 9146371489
Practice Location
Address1: 16 GUION PL
Address2:  
City: NEW ROCHELLE
State: NY
PostalCode: 108015503
CountryCode: US
TelephoneNumber: 9146325000
FaxNumber: 9146371489
Other Information
ProviderEnumerationDate: 03/20/2006
LastUpdateDate: 10/10/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0300X163439NYY Allopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine

ID Information
IDTypeStateIssuerDescription
0118217205NY MEDICAID


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