MEDICARE: DR. CARMELO MILAZZO M.D.

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	207R00000X	Internal Medicine Physician	MA060965	NJ

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	:	1760438691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARMELO MILAZZO M.D.

Provider Business Mailing Address
First Line	:	2124 NEW YORK AVE
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-4416
Country	:	US
Telephone Number	:	201-864-6492
Fax Number	:	201-865-3207

Provider Business Practice Location Address
First Line	:	2124 NEW YORK AVE
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-4416
Country	:	US
Telephone Number	:	201-864-6492
Fax Number	:	201-865-3207

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

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	07/31/2012

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