Basic Information
| Provider Information | |||||||||
| NPI: | 1528179587 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DR. GIOVANNI MARCIANO AND DR. GLENN MURACA PHYSICIANS, P.C. | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 8616 JAMAICA AVE | ||||||||
| Address2: | |||||||||
| City: | WOODHAVEN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114212042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188050037 | ||||||||
| FaxNumber: | 7188493737 | ||||||||
| Practice Location | |||||||||
| Address1: | 8616 JAMAICA AVE | ||||||||
| Address2: | |||||||||
| City: | WOODHAVEN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114212042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188050037 | ||||||||
| FaxNumber: | 7188493737 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 06/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | MARCIANO | ||||||||
| AuthorizedOfficialFirstName: | GIOVANNI | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | SECRETARY | ||||||||
| AuthorizedOfficialTelephone: | 7188050037 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 302R00000X | 185994 | NY | Y | Managed Care Organizations | Health Maintenance Organization |
No ID Information.