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General NPI Number Information
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NPI Number | 1518463868
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Entity Type | Individual
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Provider Name | KEVIN JAMES CIPRIANO MD
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Gender | Male
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Dates
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Enumeration Date | 04/04/2018
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Last Update Date | 12/01/2023
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Provider Practice Location Address
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Address Line | 9525 QUEENS BLVD
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City | REGO PARK
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State | NY
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Zip | 11374-4510
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Country | US
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Telephone | 718-925-6238
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Fax | 929-895-5109
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Provider Business Mailing Address
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Address Line | 9525 QUEENS BLVD
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City | REGO PARK
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State | NY
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Zip | 11374-4510
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Country | US
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Telephone |
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Fax |
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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 | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 91148
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 324640
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License Number State | NY
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