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General NPI Number Information
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NPI Number | 1053325357
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Entity Type | Individual
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Provider Name | ANTHONY PAUL VASTOLA MD
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Gender | Male
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Dates
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Enumeration Date | 07/29/2006
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 300 CADMAN PLZ W SUITE 1301
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City | BROOKLYN
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State | NY
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Zip | 11201-2701
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Country | US
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Telephone | 929-252-1566
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Fax | 718-208-4663
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Provider Business Mailing Address
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Address Line | 660 WHITE PLAINS RD FL 4
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City | TARRYTOWN
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State | NY
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Zip | 10591-5139
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Country | US
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Telephone | 914-984-2546
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number | 182035
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 182035
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License Number State | NY
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