1811969504 NPI number — DR. SALVATORE GIANTINOTO D.O.

Table of content: DR. SALVATORE GIANTINOTO D.O. (NPI 1811969504)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811969504 NPI number — DR. SALVATORE GIANTINOTO D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GIANTINOTO
Provider First Name:
SALVATORE
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811969504
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1010 NORTHERN BLVD STE 328
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREAT NECK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11021-5329
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-233-2484
Provider Business Mailing Address Fax Number:
516-304-5850

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8 LAUREL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST ISLIP
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11730-2131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-224-4442
Provider Business Practice Location Address Fax Number:
631-224-4446
Provider Enumeration Date:
02/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  212172 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P2165112 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 431957097 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3C3926 . This is a "HEALTHNET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0199P1 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P00154267 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 33957P . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 113447 . This is a "VYTRA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5996858 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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