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NPI Code Detail

MEDICARE: ANDRE J. CODISPOTI, M.D., P.C.

MEDICARE: ANDRE J. CODISPOTI, M.D., P.C.
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
1207KA0200XAllergy Physician0999212NY

General Provider Information

NPI Number : 1821138645
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANDRE J. CODISPOTI, M.D., P.C.
Provider Business Mailing Address
First Line : 70 GILBERT ST
Second Line : SUITE 205
City : MONROE
State : NY
Zip : 10950-1538
Country : US
Telephone Number : 845-783-0999
Fax Number : 845-783-4133
Provider Business Practice Location Address
First Line : 7 HEMION RD
Second Line :
City : SUFFERN
State : NY
Zip : 10901-4903
Country : US
Telephone Number : 845-357-0741
Fax Number : 845-357-0792
Authorized Official
Title or Position : OWNER
Name : DR. ANDRE J. CODISPOTI
Credential : M.D.
Telephone Number : 845-357-0741
Provider Enumeration Date : 02/08/2007
Last Update Date : 08/22/2020

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