Individual
DANTE D MASTRONARDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
229-231 STATE ST FL 4, BINGHAMTON, NY 13901-2756
(607) 778-1126
(607) 778-1164
Mailing address
229-231 STATE ST FL 4, BINGHAMTON, NY 13901-2756
(607) 778-1152
(607) 778-1162
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
F320026
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F401065
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0320F320026
—
NY
01
—
050301000145
FIDELIS CARE NY
NY
Enumeration date
06/12/2006
Last updated
06/22/2011
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