Healthcare Provider Details

I. General information

NPI: 1699926691
Provider Name (Legal Business Name): MIGNONE MEDICAL EYE CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2008
Last Update Date: 10/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 STEVENS AVE
MOUNT VERNON NY
10550-2534
US

IV. Provider business mailing address

955 YONKERS AVE
YONKERS NY
10704-3060
US

V. Phone/Fax

Practice location:
  • Phone: 914-664-6001
  • Fax: 914-668-0110
Mailing address:
  • Phone: 914-237-2002
  • Fax: 914-237-3002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number127335-1
License Number StateNY

VIII. Authorized Official

Name: DR. BIAGIO V. MIGNONE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 914-664-6001