Provider Demographics
NPI:1629176144
Name:AMZUTA, IOANA G (MD)
Entity Type:Individual
Prefix:
First Name:IOANA
Middle Name:G
Last Name:AMZUTA
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Gender:F
Credentials:MD
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Mailing Address - Street 1:90 PRESIDENTIAL PLZ
Mailing Address - Street 2:FIRM C
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-2240
Mailing Address - Country:US
Mailing Address - Phone:315-464-3835
Mailing Address - Fax:315-464-3837
Practice Address - Street 1:90 PRESIDENTIAL PLZ
Practice Address - Street 2:FIRM C
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-2240
Practice Address - Country:US
Practice Address - Phone:315-464-3835
Practice Address - Fax:315-464-3837
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2010-05-19
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Provider Licenses
StateLicense IDTaxonomies
NY225930207RP1001X, 207RC0200X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02377860Medicaid
NYP00749950Medicare PIN
NY02377860Medicaid