Provider Demographics
NPI:1255444097
Name:MAGLIONE, PAUL J (DPM)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:MAGLIONE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 NORTH HIGHLAND AVENUE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-6300
Mailing Address - Country:US
Mailing Address - Phone:914-941-3269
Mailing Address - Fax:914-941-0212
Practice Address - Street 1:310 NORTH HIGHLAND AVENUE
Practice Address - Street 2:SUITE 1
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-6300
Practice Address - Country:US
Practice Address - Phone:914-941-3269
Practice Address - Fax:914-941-0212
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002544213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
480922305OtherRR MCR
0778930001Medicare NSC
P29021Medicare PIN