Healthcare Provider Details

I. General information

NPI: 1881613842
Provider Name (Legal Business Name): PATRICK JOSEPH SCIORTINO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

914 BAY RIDGE PARKWAY
BKLYN NY
11228
US

IV. Provider business mailing address

914 BAY RIDGE PARKWAY
BKLYN NY
11228
US

V. Phone/Fax

Practice location:
  • Phone: 718-748-5700
  • Fax: 718-836-9236
Mailing address:
  • Phone: 718-748-5700
  • Fax: 718-836-9236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number1401411
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: