Healthcare Provider Details

I. General information

NPI: 1376468090
Provider Name (Legal Business Name): THOMAS DONATO PIGNATARO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 COMMACK RD UNIT 160
COMMACK NY
11725-5009
US

IV. Provider business mailing address

500 COMMACK RD UNIT 160
COMMACK NY
11725-5009
US

V. Phone/Fax

Practice location:
  • Phone: 831-855-1200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number354643
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: