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General NPI Number Information
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NPI Number | 1134266877
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Entity Type | Organization
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Legal Business Name | JOHN A VENDITTO MD PC
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 12/20/2014
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Provider Practice Location Address
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Address Line | 2200 NORTHERN BLVD SUITE 132
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City | GREENVALE
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State | NY
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Zip | 11548-1220
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Country | US
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Telephone | 516-626-0700
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Fax | 516-626-1190
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Provider Business Mailing Address
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Address Line | 2200 NORTHERN BLVD SUITE 132
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City | GREENVALE
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State | NY
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Zip | 11548-1220
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Country | US
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Telephone | 516-626-0700
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Fax | 516-626-1190
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN A VENDITTO
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Credential | MD, MBA, FACC
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Telephone | 516-626-0700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 185317
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License Number State | NY
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