Individual provider Active NPI

Carmen J. Giglio, D.D.S.

  • General Practice Dentistry
  • W. Haverstraw, NY
National Provider Identifier
1114002946
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
029029 Issued in NY
Practice address
5 Railroad Ave W
W Haverstraw, NY 10993-1020
Phone
(845) 947-1117
Fax
(845) 947-2796
NPI assigned
Oct 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 029029 NY Primary

Addresses

Primary practice location

5 Railroad Ave W
W Haverstraw, NY 10993-1020

Mailing address

5 Railroad Ave W
W Haverstraw, NY 10993-1020
Phone (845) 947-1117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160428001463 NY Order and Referring Only - DentistPractitioner - Dentist 4183923956

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
029029NYMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114002946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 RAILROAD AVE W",
            "city": "W HAVERSTRAW",
            "state": "NY",
            "postal_code": "109931020",
            "telephone_number": "845-947-1117",
            "fax_number": "845-947-2796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 RAILROAD AVE W",
            "city": "W HAVERSTRAW",
            "state": "NY",
            "postal_code": "109931020",
            "telephone_number": "845-947-1117",
            "fax_number": "845-947-2796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIGLIO",
        "first_name": "CARMEN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "029029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in W. Haverstraw, NY

Sources for this page

Verify at the official NPI Registry.