Healthcare Provider Details

I. General information

NPI: 1114962024
Provider Name (Legal Business Name): BIAGIO V. MIGNONE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 01/18/2020
Certification Date: 01/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 YONKERS AVE SUITE 105
YONKERS NY
10704-3060
US

IV. Provider business mailing address

955 YONKERS AVE STE 100
YONKERS NY
10704-3062
US

V. Phone/Fax

Practice location:
  • Phone: 914-237-2002
  • Fax: 914-237-3002
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
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: