1396946190 NPI number — VINCENT J. VOMERO D.D.S.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396946190 NPI number — VINCENT J. VOMERO D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VINCENT J. VOMERO D.D.S.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396946190
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 MANETTO HILL RD
Provider Second Line Business Mailing Address:
STE. 210
Provider Business Mailing Address City Name:
PLAINVIEW
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11803-1311
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-931-6055
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 MANETTO HILL RD
Provider Second Line Business Practice Location Address:
STE. 210
Provider Business Practice Location Address City Name:
PLAINVIEW
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11803-1311
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-931-6055
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
VOMERO
Authorized Official First Name:
VINCENT
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
516-931-6055

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  048342 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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