Doctor Name: | VINCENT MADONIA |
NPI Number: | 1679757017 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 071433 |
Business Practice Address: | 520 Franklin Ave Suite 103 Garden City, NY - 115305801 |
Business Phone Number: | 5167416222 |
Business Fax Number: | 5167416241 |
Mailing Address: | 520 Franklin Ave, Suite 103 GARDEN CITY |
State: | NY |
Postal Code: | 115305801 |
Phone Number: | 5167416222 |
Fax Number: | 5167416241 |
NPI Enumeration Date: | 12/20/2007 |
NPI Last Update Date: | 12/20/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 071433 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |