Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | 002603 | NY |
N | 111NR0200X | Radiology | 002603 | NY |
N | 213ER0200X | Radiology | 002603 | NY |
N | 2081S0010X | Sports Medicine | 002603 | NY |
N | 213ES0000X | Sports Medicine | 002603 | NY |
N | 213ES0103X | Foot & Ankle Surgery | 002603 | NY |
NPI | 1245319771 |
---|---|
Provider Name | Dr. Paul Damian Giovinco |
First Address | Ridgewood, NY 11385-5918 |
Second Address | Ridgewood, NY 11385-5918 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00419470 | (05) | NY |
T31892 | (02) | NY |