MEDICARE: MARY ELIZABETH DAMORE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0205X	Pediatric Endocrinology Physician	197368	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447250287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ELIZABETH DAMORE MD

Provider Business Mailing Address
First Line	:	22 SAW MILL RIVER RD
Second Line	:	2ND FLOOR
City	:	HAWTHORNE
State	:	NY
Zip	:	10532-1533
Country	:	US
Telephone Number	:	914-366-3400
Fax Number	:	914-366-3407

Provider Business Practice Location Address
First Line	:	701 N BROADWAY
Second Line	:
City	:	SLEEPY HOLLOW
State	:	NY
Zip	:	10591-1020
Country	:	US
Telephone Number	:	914-366-3400
Fax Number	:	914-366-3407

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	03/08/2016

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