Provider Demographics
NPI:1356463079
Name:D'AMBROSIO, ANTHONY LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:LOUIS
Last Name:D'AMBROSIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1200 E RIDGEWOOD AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3937
Mailing Address - Country:US
Mailing Address - Phone:201-327-8600
Mailing Address - Fax:201-327-8225
Practice Address - Street 1:1200 E RIDGEWOOD AVE STE 200
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3937
Practice Address - Country:US
Practice Address - Phone:201-327-8600
Practice Address - Fax:201-327-8225
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY220564207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery