Provider Demographics
NPI:1578670899
Name:DARMIENTO, ANTHONY ROCCO (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:ROCCO
Last Name:DARMIENTO
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 1:60 DUNNING RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-2215
Mailing Address - Country:US
Mailing Address - Phone:845-956-1222
Mailing Address - Fax:
Practice Address - Street 1:60 DUNNING RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2215
Practice Address - Country:US
Practice Address - Phone:845-956-1222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY217553207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2167839Medicaid
H15758Medicare UPIN
NY2167839Medicaid