Healthcare Provider Details

I. General information

NPI: 1255447082
Provider Name (Legal Business Name): CIPRIANO N VAMENTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 03/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1756 ROUTE 9D SUITE 102
COLD SPRING NY
10516-2619
US

IV. Provider business mailing address

50 DAYTON LN SUITE 202
PEEKSKILL NY
10566-2859
US

V. Phone/Fax

Practice location:
  • Phone: 845-265-3664
  • Fax: 845-265-4324
Mailing address:
  • Phone: 914-739-0087
  • Fax: 914-737-1714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number111019
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: