Provider Demographics
NPI:1235145376
Name:DIGIACINTO, GEORGE V (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:V
Last Name:DIGIACINTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 32564
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06150
Mailing Address - Country:US
Mailing Address - Phone:212-523-8500
Mailing Address - Fax:
Practice Address - Street 1:425 W 59TH ST
Practice Address - Street 2:STE 4E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019
Practice Address - Country:US
Practice Address - Phone:212-523-8500
Practice Address - Fax:212-523-8505
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1208751207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00299647Medicaid
NY00299647Medicaid
NY339031Medicare ID - Type Unspecified