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NPI Code Detail

MEDICARE: MICHAEL J MAGGIULLI MD

MEDICARE: MICHAEL J MAGGIULLI MD
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
1207Q00000XFamily Medicine Physician13475NY
2207Q00000XFamily Medicine Physician134751NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10108596OTHERINDEPENDENT HEALTH
20793OTHERUNIVERA
3MDA129OTHERPREFERRED CARE
4P010134751OTHERRIPA
5P010134751OTHEREXCELLUS
60000508058001OTHERBC BS OF WNY
704481310OTHERMEDICADE
822180OTHEREMPIRE
97331260OTHERAETNA

General Provider Information

NPI Number : 1114015633
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL J MAGGIULLI MD
Provider Business Mailing Address
First Line : 6966 W BERGEN
Second Line :
City : BERGEN
State : NY
Zip : 14416
Country : US
Telephone Number : 585-494-1300
Fax Number : 585-494-1132
Provider Business Practice Location Address
First Line : 16 BANK ST
Second Line :
City : BATAVIA
State : NY
Zip : 14020-2250
Country : US
Telephone Number : 585-815-6760
Fax Number : 585-344-7370
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 10/29/2019

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