Individual
SALVATORE J DEVINCENZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
70 HATFIELD LN, SUITE 101, GOSHEN, NY 10924-6734
(845) 294-8888
(845) 294-1669
Mailing address
20 GRAND STREET, 3RD FL, WARWICK, NY 10990-1035
(845) 987-3906
(845) 987-5979
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
145343
NY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
145343
NY
207RP1001X
Pulmonary Disease Physician
Primary
145343
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00787357
—
NY
01
—
110035384
RAILROAD MEDICARE PIN
NY
Enumeration date
01/12/2006
Last updated
08/21/2017
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