MEDICARE: ANTO VINCETIC DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	005796	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003804394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTO VINCETIC DPM

Provider Business Mailing Address
First Line	:	3626 E TREMONT AVE
Second Line	:	STE 102
City	:	BRONX
State	:	NY
Zip	:	10465
Country	:	US
Telephone Number	:	718-409-0400
Fax Number	:	718-518-1281

Provider Business Practice Location Address
First Line	:	3626 E TREMONT AVE STE 102
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10465-2030
Country	:	US
Telephone Number	:	718-409-0400
Fax Number	:	718-518-1281

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	07/25/2017

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Directions to “ ANTO VINCETIC DPM” Practice Location

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