Provider Demographics
NPI:1598854861
Name:IMPARATO, RICHARD M (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:M
Last Name:IMPARATO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1300 UNION TPKE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1759
Mailing Address - Country:US
Mailing Address - Phone:516-352-6777
Mailing Address - Fax:516-352-6731
Practice Address - Street 1:1300 UNION TPKE
Practice Address - Street 2:SUITE 208
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1759
Practice Address - Country:US
Practice Address - Phone:516-352-6777
Practice Address - Fax:516-352-6731
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY04187211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice