Provider Demographics
NPI:1235281866
Name:CIRILLO, VINCENZO ANTONIO (MD)
Entity Type:Individual
Prefix:MR
First Name:VINCENZO
Middle Name:ANTONIO
Last Name:CIRILLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 LOCKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801
Mailing Address - Country:US
Mailing Address - Phone:914-632-6647
Mailing Address - Fax:914-235-0552
Practice Address - Street 1:158 LOCKWOOD AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801
Practice Address - Country:US
Practice Address - Phone:914-632-6647
Practice Address - Fax:914-235-0552
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1898521207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01752414Medicaid
NY01752414Medicaid
74K901Medicare ID - Type Unspecified
F33946Medicare UPIN