Healthcare Provider Details

I. General information

NPI: 1437232956
Provider Name (Legal Business Name): GERARD DAGNESE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2006
Last Update Date: 09/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 SAW MILL RIVER RD 2ND FLOOR
YORKTOWN HTS NY
10598
US

IV. Provider business mailing address

2050 SAW MILL RIVER RD
YORKTOWN HEIGHTS NY
10598-4143
US

V. Phone/Fax

Practice location:
  • Phone: 914-245-4330
  • Fax: 914-245-0345
Mailing address:
  • Phone: 914-245-4330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number170481
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: