Provider Demographics
NPI:1225073869
Name:MIGNONE MEDICAL EYE CARE, P.C.
Entity Type:Organization
Organization Name:MIGNONE MEDICAL EYE CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BIAGIO
Authorized Official - Middle Name:V
Authorized Official - Last Name:MIGNONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-664-6001
Mailing Address - Street 1:955 YONKERS AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-3060
Mailing Address - Country:US
Mailing Address - Phone:914-237-2002
Mailing Address - Fax:914-237-3002
Practice Address - Street 1:955 YONKERS AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-3060
Practice Address - Country:US
Practice Address - Phone:914-237-2002
Practice Address - Fax:914-237-3002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127335207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01903777Medicaid
NY01903777Medicaid
NYW2L551Medicare PIN