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General NPI Number Information
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NPI Number | 1033580220
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Entity Type | Organization
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Legal Business Name | CARNEGIE ORAL & MAXILLOFACIAL SURGERY, PLLC
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Dates
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Enumeration Date | 10/13/2015
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Last Update Date | 10/13/2015
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Provider Practice Location Address
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Address Line | 200 W 57TH ST SUITE 804
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City | NEW YORK
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State | NY
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Zip | 10019-3211
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Country | US
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Telephone | 646-895-9680
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Fax |
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Provider Business Mailing Address
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Address Line | 200 W 57TH ST SUITE 804
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City | NEW YORK
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State | NY
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Zip | 10019-3211
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Country | US
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Telephone | 646-895-9680
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Fax |
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Authorized Official
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Title or Position | OWNER, SURGEON
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Name | DR. ANGELO OSTUNI
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Credential | DDS MD
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Telephone | 917-769-2744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number | 053803
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License Number State | NY
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