Healthcare Provider Details

I. General information

NPI: 1487533329
Provider Name (Legal Business Name): CARLO JOSEPH AMMATUNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 08/27/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E BETHPAGE RD
PLAINVIEW NY
11803-4228
US

IV. Provider business mailing address

1007 HANCOCK AVE
FRANKLIN SQUARE NY
11010-2105
US

V. Phone/Fax

Practice location:
  • Phone: 516-519-4243
  • Fax:
Mailing address:
  • Phone: 516-519-4243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: