| Doctor Name: | PATRICK M AMBROSIO |
| NPI Number: | 1295765675 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | MB067817 |
| Business Practice Address: | 485 Route 1 S Bldg. B. Suite 350 Iselin, NJ - 088303009 |
| Business Phone Number: | 7325493934 |
| Business Fax Number: | 7325497250 |
| Mailing Address: | 560 White Plains Road, Suite 500 - Enta TARRYTOWN |
| State: | NY |
| Postal Code: | 105915112 |
| Phone Number: | 9149842534 |
| Fax Number: | 9142411176 |
| NPI Enumeration Date: | 07/03/2006 |
| NPI Last Update Date: | 11/15/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207KA0200X |
| License Number: | MB067817 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Allergy & Immunology |
| Taxonomy Specialization: | Allergy |
| Taxonomy Definition: | |