Healthcare Provider Details

I. General information

NPI: 1396764106
Provider Name (Legal Business Name): LOUIS RALPH DEPALO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 03/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 EAST 57TH STREET 5TH FLOOR
NEW YORK NY
10022
US

IV. Provider business mailing address

36 EAST 57TH STREET 5TH FLOOR
NEW YORK NY
10022
US

V. Phone/Fax

Practice location:
  • Phone: 212-600-2000
  • Fax: 646-537-9540
Mailing address:
  • Phone: 212-600-2000
  • Fax: 646-537-9540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number155703
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number155703
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number155703
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: