Provider Demographics
NPI:1053403840
Name:DOWIDOWICZ, ANTHONY (MD,)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:DOWIDOWICZ
Suffix:
Gender:
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 W 20TH ST APT 4C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-3569
Mailing Address - Country:US
Mailing Address - Phone:212-255-7964
Mailing Address - Fax:
Practice Address - Street 1:246 W 20TH ST APT 4C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-3569
Practice Address - Country:US
Practice Address - Phone:212-255-7964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036162899207P00000X
NY228480207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02551119Medicaid
NY917V01Medicare ID - Type Unspecified
NY02551119Medicaid