MEDICARE: DR. ATHINA GIOVANIS DO

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	208D00000X	General Practice Physician	252551	NY
2	204D00000X	Neuromusculoskeletal Medicine & OMM Physician	252551	NY

General Provider Information

NPI Number	:	1629262035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ATHINA GIOVANIS DO

Provider Business Mailing Address
First Line	:	186 CONKLINGTOWN RD
Second Line	:
City	:	GOSHEN
State	:	NY
Zip	:	10924-5621
Country	:	US
Telephone Number	:	917-593-4164
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 WEST AVE STE 105
Second Line	:
City	:	CHESTER
State	:	NY
Zip	:	10918-1053
Country	:	US
Telephone Number	:	845-360-9864
Fax Number	:	845-390-2053

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2007
Last Update Date	:	02/25/2025

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