Provider Demographics
NPI:1851514608
Name:RANDO, GIUSEPPE ROSARIO (MD)
Entity Type:Individual
Prefix:DR
First Name:GIUSEPPE
Middle Name:ROSARIO
Last Name:RANDO
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 1:85 EDGEGROVE AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-3311
Mailing Address - Country:US
Mailing Address - Phone:718-967-5908
Mailing Address - Fax:718-967-5907
Practice Address - Street 1:2165 71ST ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-5526
Practice Address - Country:US
Practice Address - Phone:718-259-7100
Practice Address - Fax:718-923-2191
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182915207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01634880Medicaid
NYE89078Medicare UPIN
NY01634880Medicaid