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General NPI Number Information
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NPI Number | 1700010469
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Entity Type | Organization
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Legal Business Name | REGO PARK MEDICAL CARE, P.C.
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Dates
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Enumeration Date | 05/11/2009
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Last Update Date | 05/11/2009
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Provider Practice Location Address
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Address Line | 6135 WOODHAVEN BLVD
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City | REGO PARK
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State | NY
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Zip | 11374-2739
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Country | US
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Telephone | 718-429-6630
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Fax | 718-429-6584
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Provider Business Mailing Address
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Address Line | 6135 WOODHAVEN BLVD
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City | REGO PARK
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State | NY
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Zip | 11374-2739
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Country | US
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Telephone | 718-429-6630
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Fax | 718-429-6584
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD P GIOVANELLI
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Credential | M.D.
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Telephone | 718-429-6630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 153643-2
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 126766-2
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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 | 025361-1
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 153423-1
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License Number State | NY
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