Healthcare Provider Details

I. General information

NPI: 1275225419
Provider Name (Legal Business Name): DENISE GIANELLI PASCUAL LOPEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2023
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 LAKE ST
NEWBURGH NY
12550-5263
US

IV. Provider business mailing address

2570 ROUTE 9W STE 10
CORNWALL NY
12518-1370
US

V. Phone/Fax

Practice location:
  • Phone: 845-563-8000
  • Fax: 845-565-1364
Mailing address:
  • Phone: 845-220-3100
  • Fax: 845-534-2940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number345488
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: