Healthcare Provider Details

I. General information

NPI: 1750312260
Provider Name (Legal Business Name): VINCENT CIAMPI PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 STAFFORD DRIVE
SOUTH HUNTINGTON NY
11746-0000
US

IV. Provider business mailing address

7 STAFFORD DR
HUNTINGTON STATION NY
11746-4513
US

V. Phone/Fax

Practice location:
  • Phone: 631-547-6657
  • Fax:
Mailing address:
  • Phone: 631-547-6657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number002323-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: