Provider Demographics
NPI:1972986008
Name:CAMIOLO, AGRIPPINO
Entity Type:Individual
Prefix:
First Name:AGRIPPINO
Middle Name:
Last Name:CAMIOLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 BURTON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-3511
Mailing Address - Country:US
Mailing Address - Phone:347-258-0047
Mailing Address - Fax:212-253-2415
Practice Address - Street 1:206 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-3720
Practice Address - Country:US
Practice Address - Phone:212-253-8686
Practice Address - Fax:212-253-2415
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10017026247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other