Provider Demographics
NPI:1427085521
Name:ANGELINO, GIOVANNI (MD)
Entity type:Individual
Prefix:
First Name:GIOVANNI
Middle Name:
Last Name:ANGELINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 697
Mailing Address - Street 2:
Mailing Address - City:GOLDENS BRIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10526
Mailing Address - Country:US
Mailing Address - Phone:914-232-1393
Mailing Address - Fax:914-232-1395
Practice Address - Street 1:400 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3417
Practice Address - Country:US
Practice Address - Phone:914-232-1393
Practice Address - Fax:914-232-1395
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205462207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00007688OtherRAILROAD MEDICARE
NY02221667Medicaid
NY02221667Medicaid
NY2U0312Medicare ID - Type Unspecified
G92551Medicare UPIN