Basic Information
| Provider Information | |||||||||
| NPI: | 1972883056 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROBERTO | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | FELICE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 781 CONKLIN ST | ||||||||
| Address2: | |||||||||
| City: | FARMINGDALE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117352402 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 150 55TH ST | ||||||||
| Address2: | DEPARTMENT OF SURGERY | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112202508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186307351 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2011 | ||||||||
| LastUpdateDate: | 10/27/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 277438 | NY | Y | Allopathic & Osteopathic Physicians | Surgery | 2086S0127X | 277438 | NY | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 2086S0102X | 277438 | NY | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care |
No ID Information.