Provider Demographics
NPI:1992982201
Name:VINCENT A. CIPOLLARO M.D., P.C.
Entity type:Organization
Organization Name:VINCENT A. CIPOLLARO M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:A
Authorized Official - Last Name:CIPOLLARO
Authorized Official - Suffix:
Authorized Official - Credentials:MD PC
Authorized Official - Phone:212-588-1963
Mailing Address - Street 1:121 E 60TH ST
Mailing Address - Street 2:10 D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1117
Mailing Address - Country:US
Mailing Address - Phone:212-588-1963
Mailing Address - Fax:212-753-8229
Practice Address - Street 1:121 E 60TH ST
Practice Address - Street 2:10 D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1117
Practice Address - Country:US
Practice Address - Phone:212-588-1963
Practice Address - Fax:212-753-8229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY84708207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEY721Medicare PIN