Individual
ULRICH HERMANTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
970 N BROADWAY, SUITE 101, YONKERS, NY 10701-1309
(914) 969-1600
(914) 969-1685
Mailing address
2234 COLONIAL BLVD, MANAGED CARE DEPARTMENT, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
244312
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01317811
AMERIGROUP
NY
05
—
02902358
—
NY
01
—
1000060372
AFFINITY PROVIDER #
NY
01
—
1577058
AETNA HMO
NY
01
—
244312-A2B
HEALTH FIRST
NY
01
—
7378969
AETNA
NY
01
—
9037U1
EMPIRE BCBS - RIVERHILL
NY
01
—
P00715034
RAILROAD MEDICARE
NY
01
—
P3847380
OXFORD PROVIDER ID #
NY
01
—
UHERMANTO
NEIGHBORHOOD HEALTH PROVIDERS
NY
Enumeration date
05/25/2007
Last updated
04/05/2010
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