Divagno Interventional Cardiology MD PA

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

Legal business name

DIVAGNO INTERVENTIONAL CARDIOLOGY MD PA

Practice address

218 State RT 17 N
Suite 310
Rochelle Park, NJ 07662-3399

Phone

(201) 845-3535

Fax

(201) 845-4040

NPI assigned

Jul 15, 2006

Last updated

Nov 4, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leonardo Joseph Divagno, MD

Title

Practitioner

Phone

(201) 845-3535

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225756800000",
    "number": "1588680110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 STATE RT 17 N",
            "address_2": "SUITE 310",
            "city": "ROCHELLE PARK",
            "state": "NJ",
            "postal_code": "076623399",
            "telephone_number": "201-845-3535",
            "fax_number": "201-845-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 STATE RT 17 N",
            "address_2": "SUITE 310",
            "city": "ROCHELLE PARK",
            "state": "NJ",
            "postal_code": "076623399",
            "telephone_number": "201-845-3535",
            "fax_number": "201-845-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVAGNO INTERVENTIONAL CARDIOLOGY MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2008-11-04",
        "status": "A",
        "authorized_official_last_name": "DIVAGNO",
        "authorized_official_first_name": "LEONARDO",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRACTITIONER",
        "authorized_official_telephone_number": "201-845-3535",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "MA69173",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2656071",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8750009",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meyer Davydov, PHARMD
• Kayla Delgado, RBT
• Kevin Delucca
• Kuntal Ashwin Desai, PHARMD.
• Julie Dimatteo, PHD
• Andrea Marie Dossantos
• Easter Seals New Jersey
• Easter Seals New Jersey
• Charles Richard Effron, M.D.
• Empty Orchestra LLC

• Interventional Cardiology Physician in Rochelle Park, NJ
• Providers in Rochelle Park, NJ by specialty
• Interventional Cardiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.