Healthcare Provider Details

I. General information

NPI: 1437148228
Provider Name (Legal Business Name): ALFRED ANDREW ADAMO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 01/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 MINEOLA BLVD SUITE 320
MINEOLA NY
11501-4073
US

IV. Provider business mailing address

120 MINEOLA BLVD SUITE 320
MINEOLA NY
11501-4073
US

V. Phone/Fax

Practice location:
  • Phone: 516-663-3300
  • Fax: 516-663-2780
Mailing address:
  • Phone: 516-663-3300
  • Fax: 516-663-2780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number123994
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number123994
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number123994
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: