Provider Demographics
NPI:1699857862
Name:SAMMARTANO, ROBERT J (PA)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:SAMMARTANO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 DOGWOOD LN
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-1008
Mailing Address - Country:US
Mailing Address - Phone:718-920-7200
Mailing Address - Fax:718-547-2929
Practice Address - Street 1:MMC - DEPT. OF SURGERY
Practice Address - Street 2:3355 BAINBRIDGE AVENUE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004805363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant