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General NPI Number Information
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NPI Number | 1487947537
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Entity Type | Individual
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Provider Name | VINCENZA MINEO D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 05/24/2011
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Last Update Date | 05/07/2018
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Provider Practice Location Address
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Address Line | 1368 CLOVE RD
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City | STATEN ISLAND
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State | NY
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Zip | 10301-4303
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Country | US
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Telephone | 718-816-0237
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Fax | 718-816-5465
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Provider Business Mailing Address
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Address Line | 1368 CLOVE RD
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City | STATEN ISLAND
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State | NY
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Zip | 10301-4303
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Country | US
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Telephone | 718-816-0237
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Fax | 718-816-5465
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 25MD00307800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 193400000X
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Taxonomy Name | Single Specialty Group
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License Number | 006495
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License Number State | NY
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