Provider Demographics
NPI:1871146290
Name:IMPERATO, BRITTANY MARIE
Entity type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:MARIE
Last Name:IMPERATO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BRITTANY
Other - Middle Name:MARIE
Other - Last Name:DINUNZIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-3516
Mailing Address - Country:US
Mailing Address - Phone:631-855-2840
Mailing Address - Fax:
Practice Address - Street 1:26 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-3516
Practice Address - Country:US
Practice Address - Phone:631-855-2840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2641208174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist