MEDICARE: DR. JOSEPH D DEPIETRO M.D.

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	207Y00000X	Otolaryngology Physician	284511	NY

General Provider Information

NPI Number	:	1215258272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH D DEPIETRO M.D.

Provider Business Mailing Address
First Line	:	660 WHITE PLAINS RD FL 4
Second Line	:
City	:	TARRYTOWN
State	:	NY
Zip	:	10591-5139
Country	:	US
Telephone Number	:	914-984-2546
Fax Number	:

Provider Business Practice Location Address
First Line	:	2651 STRANG BLVD
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-2940
Country	:	US
Telephone Number	:	914-245-2681
Fax Number	:	914-245-8037

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

Provider Enumeration Date	:	06/14/2010
Last Update Date	:	10/21/2021

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