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General NPI Number Information
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NPI Number | 1457030819
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Entity Type | Organization
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Legal Business Name | YONKERS AVE MEDICAL CARE PC
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Dates
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Enumeration Date | 07/13/2023
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Last Update Date | 07/13/2023
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Provider Practice Location Address
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Address Line | 655 YONKERS AVE STE 2
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City | YONKERS
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State | NY
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Zip | 10704-2677
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Country | US
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Telephone | 914-457-8305
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Fax |
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Provider Business Mailing Address
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Address Line | 655 YONKERS AVE STE 2
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City | YONKERS
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State | NY
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Zip | 10704-2677
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PETER TOMASELLO
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Credential | DO
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Telephone | 914-457-8305
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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