Provider Demographics
NPI:1639258924
Name:BIAGIOTTI, EMILIO JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILIO
Middle Name:JOSEPH
Last Name:BIAGIOTTI
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 1:3101 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-5705
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
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186469207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01851330Medicaid
NY186469OtherLICENSE NUMBER
NYF42516Medicare UPIN