Provider Demographics
NPI:1417272485
Name:ANNA K IMPERATO MD PLLC
Entity type:Organization
Organization Name:ANNA K IMPERATO MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:K
Authorized Official - Last Name:IMPERATO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-224-5657
Mailing Address - Street 1:19 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-1921
Mailing Address - Country:US
Mailing Address - Phone:516-365-1700
Mailing Address - Fax:
Practice Address - Street 1:45 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-1928
Practice Address - Country:US
Practice Address - Phone:516-365-1700
Practice Address - Fax:516-365-7565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-02
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4146F1Medicare PIN