Basic Information
Provider Information
NPI: 1669601811
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FIORE
FirstName: PAUL
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1625 STRAITS TPKE
Address2: SUITE #201
City: MIDDLEBURY
State: CT
PostalCode: 067621836
CountryCode: US
TelephoneNumber: 2035739512
FaxNumber: 2035681240
Practice Location
Address1: 64 ROBBINS ST
Address2: 3RD FLOOR
City: WATERBURY
State: CT
PostalCode: 067082613
CountryCode: US
TelephoneNumber: 2035736263
FaxNumber: 2035736030
Other Information
ProviderEnumerationDate: 07/09/2009
LastUpdateDate: 10/20/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/20/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
208M00000X50652CTY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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