MEDICARE: DANTE TROVATO MD PC

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	261QM2500X	Medical Specialty Clinic/Center	205724	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1053564054
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANTE TROVATO MD PC

Provider Business Mailing Address
First Line	:	10216 101ST AVE
Second Line	:
City	:	OZONE PARK
State	:	NY
Zip	:	11416-2622
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10216 101ST AVE
Second Line	:
City	:	OZONE PARK
State	:	NY
Zip	:	11416-2622
Country	:	US
Telephone Number	:	718-441-4222
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DANTE TROVATO
Credential	:	MD
Telephone Number	:	718-441-4222

Provider Enumeration Date	:	11/04/2008
Last Update Date	:	11/04/2008

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