Basic Information
Provider Information
NPI: 1477633642
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STARPOLI
FirstName: ANTHONY
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 55 MONTGOMERY ST
Address2:  
City: POUGHKEEPSIE
State: NY
PostalCode: 126014106
CountryCode: US
TelephoneNumber: 8454711354
FaxNumber: 8456890610
Practice Location
Address1: 55 MONTGOMERY ST
Address2:  
City: POUGHKEEPSIE
State: NY
PostalCode: 126014106
CountryCode: US
TelephoneNumber: 8454711354
FaxNumber: 8454711476
Other Information
ProviderEnumerationDate: 10/16/2006
LastUpdateDate: 06/16/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100X173431-1NYY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


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