Organization
SIGNATURE INTEGRATED MEDICAL ARTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD BROCCOLI (PRESIDENT)
(914) 844-2864
Entity
Organization
Contact information
Practice address
220 WESTCHESTER AVE, WHITE PLAINS, NY 10604-2913
(914) 844-2864
Mailing address
150 GRAMATAN DR, YONKERS, NY 10701-5124
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
193448
NY
207L00000X
Anesthesiology Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
166111
NY
Other
Enumeration date
06/04/2013
Last updated
06/04/2013
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