MEDICARE: DR. JOSEPH L BUONO MD

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	207Q00000X	Family Medicine Physician	221424	NY

General Provider Information

NPI Number	:	1932193448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH L BUONO MD

Provider Business Mailing Address
First Line	:	4269 RICHMOND AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-6241
Country	:	US
Telephone Number	:	718-356-3541
Fax Number	:

Provider Business Practice Location Address
First Line	:	4269 RICHMOND AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-6241
Country	:	US
Telephone Number	:	718-356-3541
Fax Number	:

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

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	01/04/2016

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