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NPI Code Detail

MEDICARE: CARLA BUONVIAGGIO

MEDICARE: CARLA BUONVIAGGIO
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
1225100000XPhysical Therapist033684NY

General Provider Information

NPI Number : 1952699506
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLA BUONVIAGGIO
Provider Business Mailing Address
First Line : 31 NEW DORP LN
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10306-2351
Country : US
Telephone Number : 718-370-3500
Fax Number : 718-979-5236
Provider Business Practice Location Address
First Line : 33 RICHMOND HILL RD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-5950
Country : US
Telephone Number : 718-982-6340
Fax Number : 718-982-5358
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2011
Last Update Date : 11/08/2013

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Directions to “ CARLA BUONVIAGGIO ” Practice Location

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