Provider Demographics
NPI:1588726715
Name:TARANTO, VICTOR HUGO (MD, DO)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:HUGO
Last Name:TARANTO
Suffix:
Gender:M
Credentials:MD, DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3235 ILENE LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-2813
Mailing Address - Country:US
Mailing Address - Phone:516-872-0922
Mailing Address - Fax:516-872-5927
Practice Address - Street 1:15 FLETCHER AVE
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-4000
Practice Address - Country:US
Practice Address - Phone:516-872-0922
Practice Address - Fax:516-872-0927
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229229-1208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI041407Medicare UPIN
NY2511H1Medicare ID - Type UnspecifiedMEDICARE PROVIDER