Healthcare Provider Details

I. General information

NPI: 1427085521
Provider Name (Legal Business Name): GIOVANNI ANGELINO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E MAIN ST
MOUNT KISCO NY
10549-3417
US

IV. Provider business mailing address

PO BOX 697
GOLDENS BRIDGE NY
10526
US

V. Phone/Fax

Practice location:
  • Phone: 914-232-1393
  • Fax: 914-232-1395
Mailing address:
  • Phone: 914-232-1393
  • Fax: 914-232-1395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number205462
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number205462
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: