Healthcare Provider Details

I. General information

NPI: 1235074295
Provider Name (Legal Business Name): ANTHONY DAMBROSIO MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BLUE HILL PLZ LBBY LEVEL
PEARL RIVER NY
10965-3111
US

IV. Provider business mailing address

6 RIVERVIEW LN
HO HO KUS NJ
07423-1205
US

V. Phone/Fax

Practice location:
  • Phone: 646-552-7146
  • Fax:
Mailing address:
  • Phone: 646-552-7146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTHONY LOUIS D'AMBROSIO
Title or Position: SOLE MEMBER
Credential: MD
Phone: 646-552-7146