MEDICARE: DR. GARY A MAGGIO DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	X-002296	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	112504440	OTHER	NY	EMPIRE
2	X8X13	OTHER	NY	EMPIRE BLUE CROSS
3	10191	OTHER	NY	VYTRA
4	1518	OTHER	NY	ACCESS
5	457024	OTHER	NY	US HEALTHCARE
6	8570800	OTHER	NY	CIGNA
7	P463321	OTHER	NY	OXFORD

General Provider Information

NPI Number	:	1003810433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY A MAGGIO DC

Provider Business Mailing Address
First Line	:	671 MONTAUK HWY
Second Line	:	STE A
City	:	BAYPORT
State	:	NY
Zip	:	11705-1607
Country	:	US
Telephone Number	:	631-472-3535
Fax Number	:	631-472-8221

Provider Business Practice Location Address
First Line	:	671 MONTAUK HWY
Second Line	:	STE A
City	:	BAYPORT
State	:	NY
Zip	:	11705-1607
Country	:	US
Telephone Number	:	631-472-3535
Fax Number	:	631-472-8221

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	01/23/2008

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Directions to “ DR. GARY A MAGGIO DC” Practice Location

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