Individual provider · Type 1 NPI

Rene S. Mediavillo, MD

Specialist · Ozone Park, NY

NPI number 1376622019 Active

Practice location

9202 Liberty Ave
Ozone Park, NY 11417-1526

Call (718) 835-9729 Map

Fax (718) 925-9817

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X136585 (NY)

Specialist: 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.

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About NPI 1376622019

Rene S. Mediavillo, MD's National Provider Identifier is 1376622019, issued on Nov 3, 2006. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Ozone Park, NY. The record was last updated on Jul 9, 2007.