Provider Demographics
NPI:1942316484
Name:INTINTOLI, ANTHONY M (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:M
Last Name:INTINTOLI
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 1:270 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2787
Mailing Address - Country:US
Mailing Address - Phone:631-547-6392
Mailing Address - Fax:
Practice Address - Street 1:270 PARK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2787
Practice Address - Country:US
Practice Address - Phone:631-547-6392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT042403207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT2V4161OtherHEALTH NET
CT3561696OtherAETNA - HMO
CT034SL2OtherEMPIRE BC/BS
CT042403OtherCONNECTICARE
CT7080607OtherAETNA - PPO
CTP00210307OtherRAILROAD MEDICARE
CTTINOtherUNITED HEALTHCARE
CT5343377OtherCIGNA
CTTINOtherPRIVATE HEALTHCARE SYSTEM
CTTINOtherNEHCA HMC/PPO
CT010042403CT01OtherANTHEM BC/BS
CTP3346525OtherOXFORD HEALTH PLANS
CTTINOtherFIRST HEALTH / CCN
CTTINOtherPOMCO
CTTINOtherFOCUS
CTTINOtherNORTHEAST HEALTH DIRECT
CTTINOtherCREAT WEST
CTP3346525OtherOXFORD HEALTH PLANS
CTTINOtherUNITED HEALTHCARE