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NPI Code Detail

MEDICARE: MICHAEL JOSEPH DIGIOVANNA D.O.

MEDICARE:   MICHAEL JOSEPH DIGIOVANNA  D.O.
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
1207R00000XInternal Medicine Physician1753621NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043222755
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL JOSEPH DIGIOVANNA D.O.
Provider Business Mailing Address
First Line : 1061 N BROADWAY
Second Line :
City : NORTH MASSAPEQUA
State : NY
Zip : 11758-1802
Country : US
Telephone Number : 516-420-4300
Fax Number : 516-420-0730
Provider Business Practice Location Address
First Line : 1061 N BROADWAY
Second Line :
City : NORTH MASSAPEQUA
State : NY
Zip : 11758-1802
Country : US
Telephone Number : 516-420-4300
Fax Number : 516-420-0730
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2006
Last Update Date : 07/08/2007

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Directions to “ MICHAEL JOSEPH DIGIOVANNA D.O.” Practice Location

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