Provider Demographics
NPI:1811108277
Name:DE VITO, ROSARIO ANTONIO (DMD)
Entity type:Individual
Prefix:DR
First Name:ROSARIO
Middle Name:ANTONIO
Last Name:DE VITO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E 57TH ST
Mailing Address - Street 2:SUITE 2BC
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2805
Mailing Address - Country:US
Mailing Address - Phone:212-751-6344
Mailing Address - Fax:212-751-8458
Practice Address - Street 1:220 E 57TH ST
Practice Address - Street 2:SUITE 2BC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2805
Practice Address - Country:US
Practice Address - Phone:212-751-6344
Practice Address - Fax:212-751-8458
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0467181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice