Provider Demographics
NPI:1538232962
Name:TIO, ARSENIO MIGUEL (MD)
Entity type:Individual
Prefix:
First Name:ARSENIO
Middle Name:MIGUEL
Last Name:TIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 SHERMAN AVE
Mailing Address - Street 2:SUITE 1F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-2511
Mailing Address - Country:US
Mailing Address - Phone:212-567-4770
Mailing Address - Fax:212-544-9014
Practice Address - Street 1:231 SHERMAN AVE
Practice Address - Street 2:SUITE 1F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-2511
Practice Address - Country:US
Practice Address - Phone:212-567-4770
Practice Address - Fax:718-732-2580
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY168328208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
000111520101OtherHEALTH PLUS
NY00983500Medicaid
1683280120100OtherCOMMUNITY PREMIER PLUS
76585OtherCARE PLUS
000008736OtherAETNA
137018OtherWELLCARE
000008736OtherAETNA
NY00983500Medicaid