Provider Demographics
NPI:1710095849
Name:AMANTE, GREGORY (DPM)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:AMANTE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2952 BRIGHTON 3RD ST STE 201
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-7078
Mailing Address - Country:US
Mailing Address - Phone:718-975-4334
Mailing Address - Fax:718-975-4337
Practice Address - Street 1:2995 OCEAN PKWY APT 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8387
Practice Address - Country:US
Practice Address - Phone:718-975-3440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPO3859213E00000X
NYN0055411213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY651166987OtherMULTIPLAN
NY651166987OtherUNITED HEALTHCARE
NY010023503OtherAMERICHOICE
NY651166987Other1199 NBF
NYSP119996OtherCENTERCARE
NY6299103OtherGHI PPO
NY01995468Medicaid
NY651166987OtherMAGNACARE
NY651166987OtherGREAT WEST
NY651166987OtherEMPIRE UHC
NYP2655962OtherOXFORD
NYPH3341OtherEMPIRE BLUE CROSS