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General NPI Number Information
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NPI Number | 1366440133
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Entity Type | Individual
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Provider Name | CHRISTOPHER JOHN CIMMINO D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/14/2005
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Last Update Date | 10/22/2010
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Provider Practice Location Address
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Address Line | 83-40 WOODHAVEN BLVD
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City | GLENDALE
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State | NY
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Zip | 11385-7824
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Country | US
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Telephone | 718-441-4444
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Fax | 718-849-7854
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Provider Business Mailing Address
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Address Line | 8340 WOODHAVEN BLVD
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City | GLENDALE
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State | NY
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Zip | 11385-7824
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Country | US
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Telephone | 718-441-4444
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Fax | 718-849-7854
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | 134874
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 134874
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 134874
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 2083S0010X
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Taxonomy Name | Sports Medicine (Preventive Medicine) Physician
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License Number | 134874
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 134874
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 137874
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License Number State | NY
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Taxonomy #7
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Taxonomy Code | 209800000X
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Taxonomy Name | Legal Medicine (M.D./D.O.) Physician
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License Number | 134874
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License Number State | NY
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