Provider Demographics
NPI:1730245408
Name:CAMMARATA, ANGELO (MD)
Entity type:Individual
Prefix:DR
First Name:ANGELO
Middle Name:
Last Name:CAMMARATA
Suffix:
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 1:55 EAST 87TH STREET
Mailing Address - Street 2:SUITE 1F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1049
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:212-410-4738
Practice Address - Street 1:55 EAST 87TH STREET
Practice Address - Street 2:SUITE 1F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1049
Practice Address - Country:US
Practice Address - Phone:212-427-2131
Practice Address - Fax:212-410-4738
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY091119208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
B15937Medicare UPIN
5207411Medicare ID - Type Unspecified