MEDICARE: DR. MARY CIGLIANO DO

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	207Q00000X	Family Medicine Physician	219998	NY

General Provider Information

NPI Number	:	1306873567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY CIGLIANO DO

Provider Business Mailing Address
First Line	:	PO BOX 475
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-0475
Country	:	US
Telephone Number	:	516-208-9917
Fax Number	:	516-208-9917

Provider Business Practice Location Address
First Line	:	116 WASHINGTON BLVD
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-3032
Country	:	US
Telephone Number	:	516-208-9917
Fax Number	:	516-208-9917

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

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. MARY CIGLIANO DO” Practice Location

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