Provider Demographics
NPI:1629375860
Name:VINCENT M. D'AMICO, M.D., P.C.
Entity Type:Organization
Organization Name:VINCENT M. D'AMICO, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:MARIO
Authorized Official - Last Name:D'AMICO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-428-4400
Mailing Address - Street 1:45 TOPLAND RD
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-3001
Mailing Address - Country:US
Mailing Address - Phone:914-428-4400
Mailing Address - Fax:914-948-3509
Practice Address - Street 1:15 NORTH BROADWAY
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-2222
Practice Address - Country:US
Practice Address - Phone:914-328-8444
Practice Address - Fax:914-428-7696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-24
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY107159207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1457324923OtherNPI1
NY1457324923OtherNPI1
NYB17465Medicare UPIN