MEDICARE: PETER TAORMINO

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	332B00000X	Durable Medical Equipment & Medical Supplies	4002120002	NY

General Provider Information

NPI Number	:	1912184086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PETER TAORMINO

Provider Business Mailing Address
First Line	:	691 MONTAUK HWY
Second Line	:	STE 2
City	:	SHIRLEY
State	:	NY
Zip	:	11967-2123
Country	:	US
Telephone Number	:	631-281-6882
Fax Number	:	631-281-0869

Provider Business Practice Location Address
First Line	:	691 MONTAUK HWY
Second Line	:	STE 2
City	:	SHIRLEY
State	:	NY
Zip	:	11967-2123
Country	:	US
Telephone Number	:	631-281-6882
Fax Number	:	631-281-0869

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. KIMBERLY TAORMINO
Credential	:	SPOUSE
Telephone Number	:	631-281-6882

Provider Enumeration Date	:	01/30/2008
Last Update Date	:	03/05/2008

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