MEDICARE: SALVATORE GAUDINO DPM PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP1100X	Podiatric Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	339750101	OTHER	NY	HEALTHPLUS
2	38845	OTHER	NY	ELDERPLAN
3	P665631	OTHER	NY	OXFORD
4	5180176	OTHER	NY	AETNA PPO
5	6C4043	OTHER	NY	HEALTHNET
6	1833198	OTHER	NY	UNITED HEALTHCARE
7	2421958	OTHER	NY	AETNA USHC
8	51018P	OTHER	NY	HEALTHCARE PARTNERS
9	AC8360	OTHER	NY	ACS HEATHNET
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	0685697460001	OTHER	NY	CIGNA
12	N005093-A85	OTHER	NY	HEALTHFIRST
13	10210516A	OTHER	NY	AMERIGROUP
14	78020685697460	OTHER	NY	HORIZON
15	8999989	OTHER	NY	GHI
16	1059721	OTHER	NY	FIRSTHEALTH
17	51018P	OTHER	NY	HIP

General Provider Information

NPI Number	:	1245474725
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALVATORE GAUDINO DPM PLLC

Provider Business Mailing Address
First Line	:	420 74TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-2602
Country	:	US
Telephone Number	:	718-836-1017
Fax Number	:	718-836-9555

Provider Business Practice Location Address
First Line	:	420 74TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-2602
Country	:	US
Telephone Number	:	718-836-1017
Fax Number	:	718-836-9555

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SALVATORE C GAUDINO
Credential	:	DPM
Telephone Number	:	718-836-1017

Provider Enumeration Date	:	04/28/2009
Last Update Date	:	07/16/2015

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