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General NPI Number Information
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NPI Number | 1932145174
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Entity Type | Individual
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Provider Name | RENO G DI SCALA M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 03/25/2021
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Provider Practice Location Address
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Address Line | 2202 STEINWAY ST
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City | ASTORIA
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State | NY
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Zip | 11105-1885
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Country | US
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Telephone | 347-242-2684
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Fax | 347-242-2698
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Provider Business Mailing Address
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Address Line | 2202 STEINWAY ST
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City | ASTORIA
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State | NY
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Zip | 11105-1885
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Country | US
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Telephone | 347-242-2684
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Fax | 347-242-2698
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 163074
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License Number State | NY
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