MEDICARE: DR. JOHN JOSEPH RAINIERI D.P.M.

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	213EP1101X	Primary Podiatric Medicine Podiatrist	N004298	NY

General Provider Information

NPI Number	:	1295791242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN JOSEPH RAINIERI D.P.M.

Provider Business Mailing Address
First Line	:	23 CRESCENT LN
Second Line	:
City	:	PUTNAM VALLEY
State	:	NY
Zip	:	10579-2606
Country	:	US
Telephone Number	:	845-528-3452
Fax Number	:	914-788-4274

Provider Business Practice Location Address
First Line	:	VA HUDSON VALLEY HEALTH CARE SYSTEM
Second Line	:
City	:	MONTROSE
State	:	NY
Zip	:	10548-0100
Country	:	US
Telephone Number	:	914-497-0477
Fax Number	:	914-788-4274

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	07/11/2007

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