Individual
DOMINIC JOHN ALTIERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 NESCONSET HWY BLDG 15A, STONY BROOK, NY 11790-2554
(631) 751-2900
(631) 751-2051
Mailing address
PO BOX 13477, HAUPPAUGE, NY 11788-0768
(631) 952-5701
(631) 952-5740
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
165242-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01144930
—
NY
Enumeration date
01/29/2007
Last updated
11/02/2007
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