Provider Demographics
NPI:1538332978
Name:DR EMILIO BIAGIOTTI PHYSICIAN PC
Entity Type:Organization
Organization Name:DR EMILIO BIAGIOTTI PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILIO
Authorized Official - Middle Name:
Authorized Official - Last Name:BIAGIOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-863-7925
Mailing Address - Street 1:PO BOX 4386
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06907-0386
Mailing Address - Country:US
Mailing Address - Phone:718-863-7925
Mailing Address - Fax:718-863-8208
Practice Address - Street 1:3101 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-5705
Practice Address - Country:US
Practice Address - Phone:718-863-7925
Practice Address - Fax:718-863-8208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186469207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY186469OtherLICENSE
NYF42516Medicare UPIN