Provider Demographics
NPI:1740781665
Name:GIOVANNI BOIANO DDS PC
Entity Type:Organization
Organization Name:GIOVANNI BOIANO DDS PC
Other - Org Name:BOIANO AMBULATORY SURGICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GIOVANNI
Authorized Official - Middle Name:
Authorized Official - Last Name:BOIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-597-6500
Mailing Address - Street 1:3651 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-2036
Mailing Address - Country:US
Mailing Address - Phone:718-597-6500
Mailing Address - Fax:
Practice Address - Street 1:300 MAIN ST
Practice Address - Street 2:
Practice Address - City:EASTCHESTER
Practice Address - State:NY
Practice Address - Zip Code:10709-2916
Practice Address - Country:US
Practice Address - Phone:914-268-0020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GIOVANNI BOIANO DDS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery