Provider Demographics
NPI:1295827145
Name:MINOLA, GUISEPPE (M D)
Entity type:Individual
Prefix:
First Name:GUISEPPE
Middle Name:
Last Name:MINOLA
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:
Other - Last Name:MINOLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:40 MONTGOMERY STREET
Mailing Address - Street 2:HENRY STREET SETTLEMENT COMMUNITY CONSULTATION CENTER
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002
Mailing Address - Country:US
Mailing Address - Phone:212-233-5032
Mailing Address - Fax:212-571-4132
Practice Address - Street 1:40 MONTGOMERY STREET
Practice Address - Street 2:HENRY STREET SETTLEMENT COMMUNITY CONSULTATION CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002
Practice Address - Country:US
Practice Address - Phone:212-233-5032
Practice Address - Fax:212-571-4132
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1490632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00149063Medicaid
NY00149063Medicaid