Provider Demographics
NPI:1508829664
Name:ARDITO, ANTHONY P (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:P
Last Name:ARDITO
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 1:41 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2107
Mailing Address - Country:US
Mailing Address - Phone:516-671-6666
Mailing Address - Fax:516-674-0991
Practice Address - Street 1:41 FOREST AVE
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2107
Practice Address - Country:US
Practice Address - Phone:516-671-6666
Practice Address - Fax:516-674-0991
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY187509207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine