Healthcare Provider Details

I. General information

NPI: 1538225883
Provider Name (Legal Business Name): GEORGE OPIO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 EAST 17TH ST
NEW YORK NY
10003
US

IV. Provider business mailing address

407 AIRPORT EXEC PARK
NANUET NY
10954
US

V. Phone/Fax

Practice location:
  • Phone: 212-420-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number209849
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: