Provider Demographics
NPI:1386733715
Name:EQUINOZZI, ARTHUR II (MD)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:
Last Name:EQUINOZZI
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PENN YAN
Mailing Address - State:NY
Mailing Address - Zip Code:14527-1070
Mailing Address - Country:US
Mailing Address - Phone:315-531-2320
Mailing Address - Fax:315-350-3073
Practice Address - Street 1:207 1/2 LAKE ST
Practice Address - Street 2:
Practice Address - City:PENN YAN
Practice Address - State:NY
Practice Address - Zip Code:14527-1802
Practice Address - Country:US
Practice Address - Phone:315-536-3362
Practice Address - Fax:315-536-6836
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY220533207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY220533-4OtherWORKER'S COMP
NYP020220533OtherBLUE SHIELD
NY2593574OtherGHI
NY2152683Medicaid
NY106341BJOtherPREFERRED CARE
NYP010220533OtherBLUE CHOICE
NYP00004018OtherR.R. MEDICARE
NY106341BJOtherPREFERRED CARE
NYDD4120Medicare ID - Type Unspecified