General and Vascular Surgery of Long Island PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

GENERAL AND VASCULAR SURGERY OF LONG ISLAND PC

Practice address

434 Rockaway Ave
Brooklyn, NY 11212-5636

Phone

(718) 346-2628

Fax

(516) 248-3044

NPI assigned

Nov 15, 2006

Last updated

Feb 24, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Anthony ColantonioNPI 1750468492

Title

Owner/President

Phone

(718) 346-3355

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anthony Colantonio, MD

  • Surgery Physician
  • Brooklyn, NY
  • NPI 1750468492
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614124800000",
    "number": "1174695068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 FRANKLIN AVE",
            "address_2": "SUITE 151",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305801",
            "telephone_number": "516-746-3310",
            "fax_number": "516-746-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 ROCKAWAY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112125636",
            "telephone_number": "718-346-2628",
            "fax_number": "516-248-3044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 Franklin Ave",
            "address_2": "Suite 151",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "NY",
            "postal_code": "115305801",
            "country_code": "US",
            "telephone_number": "516-746-3310",
            "fax_number": "516-746-5610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GENERAL AND VASCULAR SURGERY OF LONG ISLAND PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A",
        "authorized_official_last_name": "COLANTONIO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "718-346-3355"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "163260",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01616568",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01513024",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.