MEDICARE: ADILIA M HORMIGO MD, PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	226250	NY

General Provider Information

NPI Number	:	1427029461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADILIA M HORMIGO MD, PHD

Provider Business Mailing Address
First Line	:	1 GUSTAVE L LEVY PLACE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-6574
Country	:	US
Telephone Number	:	212-824-8579
Fax Number	:	646-537-9639

Provider Business Practice Location Address
First Line	:	1 GUSTAVE L LEVY PLACE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10029-6574
Country	:	US
Telephone Number	:	212-824-8579
Fax Number	:	646-537-9639

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2006
Last Update Date	:	05/11/2015

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