MEDICARE: JOSEPH COMIZIO D.D.S.

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	0384731	NY

General Provider Information

NPI Number	:	1982694634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH COMIZIO D.D.S.

Provider Business Mailing Address
First Line	:	165 FISHER AVE
Second Line	:
City	:	EASTCHESTER
State	:	NY
Zip	:	10709-2608
Country	:	US
Telephone Number	:	914-779-1444
Fax Number	:	914-779-0841

Provider Business Practice Location Address
First Line	:	165 FISHER AVE
Second Line	:
City	:	EASTCHESTER
State	:	NY
Zip	:	10709-2608
Country	:	US
Telephone Number	:	914-779-1444
Fax Number	:	914-779-0841

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	09/04/2007

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Directions to “ JOSEPH COMIZIO D.D.S.” Practice Location

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