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Individual

DR. VITO FODERA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
763 LARKFIELD RD, COMMACK, NY 11725-3131
(631) 489-5000
(631) 858-1990
Mailing address
763 LARKFIELD RD, COMMACK, NY 11725-3131
(631) 489-5000
(631) 858-1990

Taxonomy

Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
60264556
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
A400090538
NY
Enumeration date
03/14/2012
Last updated
02/19/2014
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