MEDICARE: GREGORY G. CARNEVALE,M.D,L.L.C.

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	207Y00000X	Otolaryngology Physician
2	207YX0602X	Otolaryngic Allergy Physician

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	:	1780765370
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREGORY G. CARNEVALE,M.D,L.L.C.

Provider Business Mailing Address
First Line	:	784 PRE EMPTION RD
Second Line	:
City	:	GENEVA
State	:	NY
Zip	:	14456-2018
Country	:	US
Telephone Number	:	315-789-2153
Fax Number	:	315-789-4781

Provider Business Practice Location Address
First Line	:	784 PRE EMPTION RD
Second Line	:
City	:	GENEVA
State	:	NY
Zip	:	14456-2018
Country	:	US
Telephone Number	:	315-789-2153
Fax Number	:	315-789-4781

Authorized Official
Title or Position	:	OWNER
Name	:	GREGORY G CARNEVALE
Credential	:	M.D.
Telephone Number	:	315-789-2153

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	09/11/2025

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