Individual
GINO A CONSIGLIERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7 MEDICAL DR STE A, PORT JEFFERSON STATION, NY 11776-1593
(631) 928-5252
(631) 928-5259
Mailing address
7 MEDICAL DR STE A, PORT JEFFERSON STATION, NY 11776-1593
(631) 928-5252
(631) 928-5259
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
109169
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
182279
AETNA US HEALTH
NY
01
—
692668
UNITER HEALTHCARE
—
01
—
AJ45668
MDNY
—
01
—
CCLI1312
VYTRA
—
01
—
GC0625781
BLUE CROSS
—
01
—
P44353103
MULITPLAN
—
Enumeration date
12/28/2006
Last updated
07/08/2007
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