Healthcare Provider Details

I. General information

NPI: 1255586335
Provider Name (Legal Business Name): DRS. VOLZ & AMATO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2008
Last Update Date: 11/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 BEYER DR
POUGHQUAG NY
12570-5636
US

IV. Provider business mailing address

PO BOX 737
LAKE KATRINE NY
12449-0737
US

V. Phone/Fax

Practice location:
  • Phone: 914-388-9275
  • Fax:
Mailing address:
  • Phone: 845-247-0668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number011877-1
License Number StateNY

VIII. Authorized Official

Name: MR. FRANK VOLZ
Title or Position: OWNER
Credential:
Phone: 518-398-5432