Provider Demographics
NPI:1619047255
Name:MAGLIATO, HENRY JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:JOHN
Last Name:MAGLIATO
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:P.O. BOX 2326
Mailing Address - Street 2:
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:914-589-7668
Mailing Address - Fax:917-636-8662
Practice Address - Street 1:341 DAISY FARMS DR
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583
Practice Address - Country:US
Practice Address - Phone:212-861-0055
Practice Address - Fax:914-636-8662
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0833111207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB10679Medicare UPIN
NYB-10679NYMedicare UPIN