Provider Demographics
NPI:1154426229
Name:FLORIO, WILLIAM ANTHONY JR (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ANTHONY
Last Name:FLORIO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12 DOGWOOD LN
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:CT
Mailing Address - Zip Code:06883-1904
Mailing Address - Country:US
Mailing Address - Phone:917-273-2997
Mailing Address - Fax:
Practice Address - Street 1:8502 67TH AVE
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-5214
Practice Address - Country:US
Practice Address - Phone:917-273-2997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1281822084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00276366Medicaid
NY03062Medicare ID - Type UnspecifiedGHI
NY00276366Medicaid
NY67A981Medicare ID - Type UnspecifiedEMPIRE