Provider Demographics
NPI:1659580660
Name:CIPRIANO N. VAMENTA III
Entity Type:Organization
Organization Name:CIPRIANO N. VAMENTA III
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:CIPRIANO
Authorized Official - Middle Name:N
Authorized Official - Last Name:VAMENTA
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:845-265-3664
Mailing Address - Street 1:1756 ROUTE 9D
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:NY
Mailing Address - Zip Code:10516-2619
Mailing Address - Country:US
Mailing Address - Phone:845-265-3664
Mailing Address - Fax:845-265-4324
Practice Address - Street 1:1756 ROUTE 9D
Practice Address - Street 2:
Practice Address - City:COLD SPRING
Practice Address - State:NY
Practice Address - Zip Code:10516-2619
Practice Address - Country:US
Practice Address - Phone:845-265-3664
Practice Address - Fax:845-265-4324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY56858EW611Medicare PIN
NYWEW611Medicare PIN