Healthcare Provider Details

I. General information

NPI: 1033580220
Provider Name (Legal Business Name): CARNEGIE ORAL & MAXILLOFACIAL SURGERY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2015
Last Update Date: 10/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W 57TH ST SUITE 804
NEW YORK NY
10019-3211
US

IV. Provider business mailing address

200 W 57TH ST SUITE 804
NEW YORK NY
10019-3211
US

V. Phone/Fax

Practice location:
  • Phone: 646-895-9680
  • Fax:
Mailing address:
  • Phone: 646-895-9680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number053803
License Number StateNY

VIII. Authorized Official

Name: DR. ANGELO OSTUNI
Title or Position: OWNER, SURGEON
Credential: DDS MD
Phone: 917-769-2744