Basic Information
| Provider Information | |||||||||
| NPI: | 1629375860 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VINCENT M. D'AMICO, M.D., P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 45 TOPLAND RD | ||||||||
| Address2: | |||||||||
| City: | HARTSDALE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105303001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144284400 | ||||||||
| FaxNumber: | 9149483509 | ||||||||
| Practice Location | |||||||||
| Address1: | 15 NORTH BROADWAY | ||||||||
| Address2: | |||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 106012222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9143288444 | ||||||||
| FaxNumber: | 9144287696 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2011 | ||||||||
| LastUpdateDate: | 04/05/2011 | ||||||||
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| AuthorizedOfficialLastName: | D'AMICO | ||||||||
| AuthorizedOfficialFirstName: | VINCENT | ||||||||
| AuthorizedOfficialMiddleName: | MARIO | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9144284400 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 107159 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 1457324923 | 01 | NY | NPI1 | OTHER |