Provider Demographics
NPI:1467611061
Name:MICHELINE GIOVANI PHYSICIAN, PC
Entity Type:Organization
Organization Name:MICHELINE GIOVANI PHYSICIAN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIOVANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-921-0524
Mailing Address - Street 1:262 PURCHASE ST
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-2102
Mailing Address - Country:US
Mailing Address - Phone:914-921-0524
Mailing Address - Fax:
Practice Address - Street 1:262 PURCHASE ST
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-2102
Practice Address - Country:US
Practice Address - Phone:914-921-0524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228207208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5316B1Medicare PIN