Provider Demographics
NPI:1255447082
Name:VAMENTA, CIPRIANO N (MD)
Entity type:Individual
Prefix:
First Name:CIPRIANO
Middle Name:N
Last Name:VAMENTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:50 DAYTON LN
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2859
Mailing Address - Country:US
Mailing Address - Phone:914-739-0087
Mailing Address - Fax:914-737-1714
Practice Address - Street 1:1756 ROUTE 9D
Practice Address - Street 2:SUITE 102
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
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2010-03-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY111019207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB16638Medicare UPIN
NY568581Medicare PIN