Healthcare Provider Details

I. General information

NPI: 1699794651
Provider Name (Legal Business Name): JOSEPH J. SCIORTINO JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 10/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

916 BAY RIDGE PKWY
BKLYN NY
11228
US

IV. Provider business mailing address

916 BAY RIDGE PKWY
BKLYN NY
11228
US

V. Phone/Fax

Practice location:
  • Phone: 718-745-0002
  • Fax: 718-745-8841
Mailing address:
  • Phone: 718-745-0002
  • Fax: 718-745-8841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number156278
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: