Provider Demographics
NPI:1982619615
Name:COTUGNO, STEFFANI L (DO)
Entity Type:Individual
Prefix:DR
First Name:STEFFANI
Middle Name:L
Last Name:COTUGNO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:711 TROY SCHENECTADY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2461
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:939 ROUTE 146 STE 700
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3662
Practice Address - Country:US
Practice Address - Phone:518-383-0891
Practice Address - Fax:518-383-1662
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY197586207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000401506001OtherBSNENY
NY47327OtherGHI/HMO
NY200087OtherSENIOR WHOLE HEALTH
NY08310OtherMVP
NY692101OtherEMPIRE BC
NY5548679OtherAETNA
NY070216000043OtherFIDELIS
NY10000404OtherCDPHP
NY01668271Medicaid
NY200087OtherSENIOR WHOLE HEALTH
NYG23927Medicare UPIN