Basic Information
| Provider Information | |||||||||
| NPI: | 1699778977 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DELSAVIO | ||||||||
| FirstName: | GINA | ||||||||
| MiddleName: | C. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 155 CRYSTAL RUN RD | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109414057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8457036999 | ||||||||
| FaxNumber: | 8457036297 | ||||||||
| Practice Location | |||||||||
| Address1: | 219 BLOOMING GROVE TPKE | ||||||||
| Address2: | |||||||||
| City: | NEW WINDSOR | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125537769 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8455618060 | ||||||||
| FaxNumber: | 8455618523 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2005 | ||||||||
| LastUpdateDate: | 08/10/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 192639 | NY | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XS0106X | 192639 | NY | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery |
ID Information
| ID | Type | State | Issuer | Description | 0910348 | 01 | NY | AETNA HMO # | OTHER | 67H403 | 01 | NY | EMPIRE BC/BS (NEW PALTZ) | OTHER | 5481210 | 01 | NY | AETNA PPO # | OTHER | 000000032781 | 01 | NY | GHI HMO # | OTHER | 200025439 | 01 | NY | RR MDCR # | OTHER | 67H401 | 01 | NY | EMPIRE BC/BS (NEW WINDSR) | OTHER | 141796305 | 01 | NY | TAX IDENTIFICATION # | OTHER | 01666848 | 05 | NY | MEDICAID | 0599985 | 01 | NY | GHI PPO # | OTHER | 956374 | 01 | NY | MVP PROVIDER # | OTHER | P378075 | 01 | NY | OXFORD PROVIDER # | OTHER | 010192639NY01 | 01 | NY | ANTHEM HEALTH # | OTHER |