MEDICARE: DR. JOHN A. VENDITTO M.D.,MBA,F.A.C.C.

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	207RI0011X	Interventional Cardiology Physician	185317	NY

General Provider Information

NPI Number	:	1750359444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN A. VENDITTO M.D.,MBA,F.A.C.C.

Provider Business Mailing Address
First Line	:	2200 NORTHERN BLVD
Second Line	:	SUITE 132
City	:	GREENVALE
State	:	NY
Zip	:	11548-1220
Country	:	US
Telephone Number	:	516-626-0700
Fax Number	:	516-626-1190

Provider Business Practice Location Address
First Line	:	2200 NORTHERN BLVD
Second Line	:	SUITE 132
City	:	GREENVALE
State	:	NY
Zip	:	11548-1220
Country	:	US
Telephone Number	:	516-626-0700
Fax Number	:	516-626-1190

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

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	12/20/2014

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