Provider Demographics
NPI:1821087305
Name:SAVINO, THOMAS VINCENT (MD)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:VINCENT
Last Name:SAVINO
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 1:65 BUTTONWOOD RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-1246
Mailing Address - Country:US
Mailing Address - Phone:718-667-4981
Mailing Address - Fax:
Practice Address - Street 1:1487 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-2311
Practice Address - Country:US
Practice Address - Phone:718-979-3643
Practice Address - Fax:718-987-2655
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202245207R00000X
NJMA64590207R00000X
FLME0076915207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01704672Medicaid
NY763091Medicare PIN
NYG29892Medicare UPIN