Healthcare Provider Details

I. General information

NPI: 1841375235
Provider Name (Legal Business Name): ALBERT A PANOZZO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MMC-ORTHOPEDIC SURGERY 3400 BAINBRIDGE AVENUE, 6TH FL
BRONX NY
10467
US

IV. Provider business mailing address

567 FORT WASHINGTON AVE APT 2B
NEW YORK NY
10033-1917
US

V. Phone/Fax

Practice location:
  • Phone: 718-920-2060
  • Fax:
Mailing address:
  • Phone: 718-920-2060
  • Fax: 718-653-1587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number002270
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number002270
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: