Organization Active NPI

Associated Medical Professionals of Ny, PLLC

  • Urology Physician
  • Auburn, NY
National Provider Identifier
1407197486
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
ASSOCIATED MEDICAL PROFESSIONALS OF NY, PLLC
Practice address
192 Genesee St
Auburn, NY 13021-3361
Phone
(315) 258-5253
Fax
(315) 258-0202
NPI assigned
Mar 15, 2013
Organization subpart
Yes
Parent organization
ASSOCIATED MEDICAL PROFESSIONALS OF NY, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Authorized official

Name
Dr. Angelo R. Derosalia, MD
Title
Authorized Official
Phone
(315) 458-3343

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

192 Genesee St
Auburn, NY 13021-3361

Mailing address

100 Metropolitan Park Dr Ste 100
Liverpool, NY 13088-5842
Phone (315) 870-9370

National Provider Directory

National Provider Directory
Part of
Associated Medical Professionals of Ny PLLC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1363305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1407197486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 METROPOLITAN PARK DR STE 100",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130885842",
            "telephone_number": "315-870-9370",
            "fax_number": "315-870-9364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 GENESEE ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130213361",
            "telephone_number": "315-258-5253",
            "fax_number": "315-258-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED MEDICAL PROFESSIONALS OF NY, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ASSOCIATED MEDICAL PROFESSIONALS OF NY, PLLC",
        "enumeration_date": "2013-03-15",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A",
        "authorized_official_last_name": "DEROSALIA",
        "authorized_official_first_name": "ANGELO",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "315-458-3343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.