Provider Demographics
NPI:1215331384
Name:FIORE, JULIA ROSE (MHS, PA-C)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ROSE
Last Name:FIORE
Suffix:
Gender:F
Credentials:MHS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1176 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-3958
Mailing Address - Country:US
Mailing Address - Phone:413-331-3676
Mailing Address - Fax:413-331-4489
Practice Address - Street 1:1176 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-3958
Practice Address - Country:US
Practice Address - Phone:413-331-3676
Practice Address - Fax:413-331-4489
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA5183363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110123265AMedicaid