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General NPI Number Information
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NPI Number | 1134405723
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Entity Type | Organization
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Legal Business Name | DOMINICK GOLIO M.D., P.C.
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Dates
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Enumeration Date | 10/26/2011
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Last Update Date | 10/26/2011
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Provider Practice Location Address
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Address Line | 935 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10028-0212
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Country | US
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Telephone | 305-534-0121
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Fax | 212-628-8881
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Provider Business Mailing Address
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Address Line | 100 EAST 81ST STREET
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City | NEW YORK
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State | NY
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Zip | 10028
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Country | US
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Telephone | 305-534-0121
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Fax | 212-628-8881
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | DOMINICK GOLIO
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Credential | M.D.
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Telephone | 212-628-8880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 236097
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License Number State | NY
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