Healthcare Provider Details

I. General information

NPI: 1356380018
Provider Name (Legal Business Name): EMILY PUNTILLO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 11/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 COMMERCE ST CARE MOUNT MEDICAL, PC
YORKTOWN HEIGHTS NY
10598-4432
US

IV. Provider business mailing address

110 S BEDFORD RD CARE MOUNT MEDICAL, PC
MOUNT KISCO NY
10549-3446
US

V. Phone/Fax

Practice location:
  • Phone: 914-241-1050
  • Fax: 914-962-0527
Mailing address:
  • Phone: 914-241-1050
  • Fax: 914-962-0527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number209804
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: