| Diane And Raymond Magliulo, Do Pc | |
|
245 W Main St Bay Shore NY 11706-8323 | |
| (631) 969-0000 | |
| (631) 969-1094 |
| Full Name | Diane And Raymond Magliulo, Do Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 245 W Main St, Bay Shore, New York |
| Authorized Official Name and Position | Diane Magliulo (PRESIDENT) |
| Authorized Official Contact | 6319690000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diane And Raymond Magliulo, Do Pc 245 W Main St Bay Shore NY 11706-8323 Ph: (631) 969-0000 | Diane And Raymond Magliulo, Do Pc 245 W Main St Bay Shore NY 11706-8323 Ph: (631) 969-0000 |
| NPI Number | 1902103864 |
|---|---|
| Provider Enumeration Date | 02/11/2011 |
| Last Update Date | 02/11/2011 |
| Medicare PECOS PAC ID | 9234317371 |
|---|---|
| Medicare Enrollment ID | O20110621000141 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902103864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 183975 (New York) | Primary |
| 261QP2300X | Clinic/center - Primary Care | 183013 (New York) | Secondary |
| Provider Name | Diane H Magliulo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528141652 PECOS PAC ID: 1254501331 Enrollment ID: I20110829000075 |
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