Provider Demographics
NPI:1437148228
Name:ADAMO, ALFRED ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:ANDREW
Last Name:ADAMO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:120 MINEOLA BLVD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4073
Mailing Address - Country:US
Mailing Address - Phone:516-663-3300
Mailing Address - Fax:516-663-2780
Practice Address - Street 1:120 MINEOLA BLVD
Practice Address - Street 2:SUITE 320
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4073
Practice Address - Country:US
Practice Address - Phone:516-663-3300
Practice Address - Fax:516-663-2780
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY123994207YX0007X, 208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00542214Medicaid
NY00542214Medicaid
C09530Medicare UPIN