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NPI Code Detail

MEDICARE: JOHN BAGLIONI RD

MEDICARE: JOHN BAGLIONI RD
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
1133V00000XRegistered Dietitian005411NY

General Provider Information

NPI Number : 1518140904
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN BAGLIONI RD
Provider Business Mailing Address
First Line : 3131 GRAND CONCOURSE APT 9A
Second Line :
City : BRONX
State : NY
Zip : 10468-1411
Country : US
Telephone Number : 718-219-6069
Fax Number :
Provider Business Practice Location Address
First Line : 3131 GRAND CONCOURSE APT 9A
Second Line :
City : BRONX
State : NY
Zip : 10468-1411
Country : US
Telephone Number : 718-219-6069
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2007
Last Update Date : 06/21/2024

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