Provider Demographics
NPI:1861445926
Name:GERMANO, JOSEPH J (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:GERMANO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:120 MINEOLA BLVD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4073
Mailing Address - Country:US
Mailing Address - Phone:516-663-4480
Mailing Address - Fax:516-663-8546
Practice Address - Street 1:120 MINEOLA BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4073
Practice Address - Country:US
Practice Address - Phone:516-663-4480
Practice Address - Fax:516-663-8546
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225971207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02797611Medicaid
NY02797611Medicaid