Provider Demographics
NPI:1740212166
Name:AMENT, JOSEPH D (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:D
Last Name:AMENT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0208
Mailing Address - Country:US
Mailing Address - Phone:212-410-6200
Mailing Address - Fax:212-534-5570
Practice Address - Street 1:920 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0208
Practice Address - Country:US
Practice Address - Phone:212-410-6200
Practice Address - Fax:212-534-5570
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142439207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00814195Medicaid
NYB20607Medicare UPIN
NY00814195Medicaid