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General NPI Number Information
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NPI Number | 1871664979
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Entity Type | Individual
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Provider Name | VIRGILIO ANSAY
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Gender | Male
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Dates
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Enumeration Date | 11/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1095 FLATBUSH AVE
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City | BROOKLYN
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State | NY
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Zip | 11226-6141
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Country | US
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Telephone | 718-240-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 80 MARCUS DR PROVIDER ENROLLMENT
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City | MELVILLE
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State | NY
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Zip | 11747-4230
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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 |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 201344
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License Number State | NY
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