Organization Active NPI

Associated Medical Professionals of Ny, PLLC

  • Urology Physician
  • New Hartford, NY
National Provider Identifier
1497039127
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
2 Ellinwood Dr
New Hartford, NY 13413-1110
Phone
(315) 724-1012
Fax
(315) 724-5219
NPI assigned
Sep 29, 2011
Last updated
Jul 15, 2020By the provider in NPPES
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 Physician 208800000X NU Primary

Addresses

Primary practice location

2 Ellinwood Dr
New Hartford, NY 13413-1110

Mailing address

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

Other names 1

  • New Hartford Division - 2 Ellinwood Other name

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": "1317254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1497039127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 METROPOLITAN PARK DR.",
            "address_2": "SUITE 100",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130885842",
            "telephone_number": "315-870-9370",
            "fax_number": "315-558-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ELLINWOOD DR",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134131110",
            "telephone_number": "315-724-1012",
            "fax_number": "315-724-5219"
        }
    ],
    "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": "2011-09-29",
        "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": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Hartford Division - 2 Ellinwood",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "New Hartford Division - 2 Ellinwood",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Hartford, 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.